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Study: Race Matters in Nursing Home Quality

BySUSAN KANSAGRA, M.D.ABC News Medical Unit
September 10, 2007, 9:18 PM

Sept. 11, 2007 — -- In decades past, Southern states frequently were associated with racial segregation.

However, a study published today in the journal Health Affairs sheds new light on the concept of segregation as it relates to a modern-day arena — nursing homes.

And this time, the South comes out clean.

Researchers at Temple University in Philadelphia, and Brown University in Providence, R.I., analyzed the quality and racial makeup of nursing homes.

What they found was distressing.

"We found that there were big differences between quality of nursing home care that blacks received as opposed to whites," said David Barton Smith, professor emeritus in the Fox School of Business at Temple University and lead author of the paper. "This was related largely to where they received their care."

Researchers looked at every nursing home across the United States and they assigned each metropolitan region a score reflecting the level of segregation among its nursing homes.

The Midwest was found to be the most segregated, with areas such as Cleveland, Milwaukee, Detroit, Chicago and Cincinnati ranking in the Top 10.

The South was actually the least segregated, with nursing homes there more likely to have racially mixed resident populations.

The nursing homes were then ranked along quality indicators such as patient-to-staff ratio and inspection deficiencies. Black nursing home residents were more likely to be in a facility with potentially hazardous deficiencies.

Study co-author Jacqueline Zinn, professor in the Fox School of Business at Temple University, notes that the differences in the care received by black nursing home residents and their white counterparts were not "within-home" differences.

"The care provided within the facility is consistent," she said. "It's just differences across [regions] with regard to the degree of segregation."

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