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Health Affairs, 26, no. 5 (2007): 1448-1458
doi: 10.1377/hlthaff.26.5.1448
© 2007 by Project HOPE
 
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DataWatch

Separate And Unequal: Racial Segregation And Disparities In Quality Across U.S. Nursing Homes

David Barton Smith, Zhanlian Feng, Mary L. Fennell, Jacqueline S. Zinn and Vincent Mor

We describe the racial segregation in U.S. nursing homes and its relationship to racial disparities in the quality of care. Nursing homes remain relatively segregated, roughly mirroring the residential segregation within metropolitan areas. As a result, blacks are much more likely than whites to be located in nursing homes that have serious deficiencies, lower staffing ratios, and greater financial vulnerability. Changing health care providers’ behavior will not be sufficient to eliminate disparities in medical treatment in nursing homes. Persistent segregation among homes poses a substantial barrier to progress.


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