Abstract
Disparities in older adults’ care and experiences in long-term care facilities (LTCFs) such as nursing homes and assisted living/residential care communities reflect disparities in the broader society. Various policies and institutional practices related to economic opportunity, education, housing, health care, and retirement financing have created and maintain inequitable social structures in the United States. This chapter describes racial and ethnic disparities among older adults in LTCFs in the United States and the systemic factors associated with those disparities. It presents a conceptual framework for understanding the role of structural racism in the racial and ethnic inequities experienced by LTCF residents. In the framework, structural racism directly contributes to racial and ethnic inequities among LTCF residents through LTCF-related policies and practices. Structural racism also indirectly causes disparities among LTCF residents through health and economic disparities. The chapter describes current efforts that address the effects of structural racism within LTCFs and concludes with practice and policy recommendations to redress racial and ethnic disparities among LTCF residents.
Highlights
Structural racism affects individuals and communities across the life course
Effective Elimination of Structural Racism living communities; quality of care and quality of life in long-term care facilities (LTCFs); health outcomes as LTCF residents; and social engagement within LTCFs. These disparities are associated with a variety of structural factors
Nursing homes tend to be quite segregated by race and ethnicity [15], a phenomenon related to past structural racism
Summary
For older Americans, inequities in health access, quality, and outcomes caused by racism and systemic barriers in the United States can be exacerbated in later life in a variety of domains including physical and cognitive health, mortality rates, and quality of care. Systems for care in later life include long-term care facilities (LTCFs) such as nursing homes and assisted living/residential care communities. Older adults of color in the United States experience disparities in access to quality nursing homes; access to care in assisted.
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