II. African Americans Can't Win: Racial Disparities in Accessing Nursing Home Care

Ruqaiijah Yearby, African Americans Can't Win, Break Even, or Get out of the System: The Persistence of “Unequal Treatment” in Nursing Home Care, 82 Temple Law Review 1177 (Spring-Summer 2010) (214 Footnotes).


Nursing homes are the central institutional provider of care for the elderly.   In the 1980s and 1990s, more Caucasians used nursing homes than African Americans, and research showed that African Americans were denied access to nursing homes because of their race.   For instance, in 1984, a study of New York nursing homes showed that nursing homes that provided excellent quality of care demonstrated a pattern of admitting Caucasians over African Americans.   The study was based on civil rights documents submitted by nursing homes to the New York State Health Department.  

Almost a decade later, in 1992, the New York State Advisory Committee to the U.S. Commission on Civil Rights (“Advisory Committee”) reported that there were still significant racial inequities in nursing home admissions between African Americans and Caucasians.   The Advisory Committee's findings showed that Caucasian patients were three times more likely to get into a quality nursing home than minority patients. According to the report, Caucasian patients were admitted to quality nursing homes while racial minorities were relegated to substandard quality nursing *1183 homes.   This racial segregation in nursing homes persists even though African Americans' use of nursing homes is greater than Caucasians' use.

In 2004, nursing homes provided care to 1.5 million elderly and disabled persons, with the average length of stay being 835 days.   By 2050, nursing homes are projected to provide care to 6.6 million elderly and disabled persons.   By 2004, African Americans' use of nursing homes was thirty-two percent higher than Caucasians' use.   Yet, two-thirds of all African American nursing home residents reside in just ten percent of all facilities.  

A 2007 national study of nursing homes found that the nursing homes that house African Americans tend to be racially segregated.   As a result of the concentration of African Americans in a small number of nursing homes, these facilities are often designated as predominately African American facilities.   Thus, even with increased use of nursing homes, African Americans still cannot win equal access to nursing home care.

Denied access to diverse nursing homes, African Americans are relegated to racially segregated poorly performing nursing homes. These nursing homes not only cause African Americans to suffer harm,   but the government also rates them poorly.