After analyzing data recorded between 1999 and 2004 from more than 11,500 nursing homes across the country, the team of researchers found that nursing homes serving white residents tend to be better off, both in terms of their finances and their health outcomes. “There is no simple fix,” one of the researchers, Latarsha Chisholm, noted. “It is a complex issue, but we need to address it because disparities are everyone’s issue.”
Although racial disparities can be difficult to pinpoint, Chisholm and her colleagues suspect their findings are due to several factors. Residential segregation plays a part, since black Americans tend to retire to facilities in their communities that are already serving a large number of other African American patients. Socioeconomic disparities are also at play. Black retireees are more likely to rely on Medicaid to pay their nursing home bills, but the reimbursement rates for Medicaid are lower. That means the nursing homes serving primarily Medicaid patients tend to have fewer financial resources — while the one with more resources often turn Medicaid beneficiaries away.
The researchers acknowledged that although Obamacare doesn’t do anything to directly address the racial disparities in the long-term care sector, the health law may help ensure that people have better access to preventative care. “An indirect benefit of the healthcare plan I see is that perhaps there will be better continuity of care in a person’s earlier years,” Chisholm explained. “So their problems may be better managed early on and that could reduce costs and complications as they age and enter a nursing home. But other than that, the plan doesn’t address the financing of long-term care.”
Nursing home care has become increasingly more expensive in recent years. At this point, the median cost of living in a nursing home is two and a half times more expensive than the average private college tuition. Despite the relatively generous coverage that Medicare provides, one in four American seniors go bankrupt because of high out-of-pocket health costs after they retire.
There are countless other examples of racial inequity displaying itself in the health care industry. Black Americans are less likely to have access to surgical and emergency medical care, more likely to patronize hospitals that employ less-experienced staff, much less likely to receive high-quality primary care, more likely to suffer from fatal diseases, and ultimately more likely to die younger. Some researchers suspect that less funding is awarded to research projects focusing on diseases that disproportionately affect black people, and studies have found that two-thirds of doctors harbor “unconscious racial biases” toward their African American patients.