A new study appearing in the Archives of Internal Medicine on nursing home closings in the past decade reports that poor, urban, and minority neighborhoods have been the hardest hit by the closures of the past 10 years. In the last decade there has been a 5 percent drop in available nursing home beds in America. Meanwhile, more than 27 million Americans will need long term care by 2050, nearly twice as many as in 2000. Where will they go?
Using U.S. Census data from 2000, the study showed overall closure rates were about twice as high in zip codes that are home to low-income and minority communities than in the richest zip codes. Nursing homes in census areas made up of mainly low-income Hispanic or African American residents were 37 and 38 percent more likely, respectively, to close than other areas. Shockingly, almost half of all hospital-based nursing homes in the country closed in the last ten years.
"There are times when placement in a nursing home is unavoidable," said Dr. Mitchell H. Katz, director of the Los Angeles County Department of Health Services, who wrote an accompanying editorial to the study. "And then what we should want is a high-quality nursing home that is near where a person has lived all their life and where their family and friends are. And what's disturbing about this investigation is that it shows that nursing home closures are not random. And that they are more likely to occur in low-income neighborhoods."
Big changes are going to have to occur, according to the study or only the wealthy will have access to nursing homes, the authors said. With a growing aging population, emphasis on prevention and assisted living and home care types of care will need to be emphasized.