The University of Minnesota’s School of Public Health will lead a comprehensive study of racial disparities in nursing homes and how that relates to quality of life and quality of care.
This expands on the team’s preliminary findings, which identified minority nursing home residents had markedly lower quality of life, despite accounting for a host of other factors. The study is funded by the National Institute on Minority and Health Disparities through the National Institutes of Health (NIH), totaling to about $1.8 million in grant funding over the course of five years.
“This has not been studied comprehensively before,” said primary investigator, Tetyana Shippee, Ph.D., assistant professor in the School of Public Health. “There is a major demographic shift happening in nursing homes, but we know so little about quality of life and quality of care for those populations.”
By 2030, minorities are expected to be overrepresented in nursing homes. In fact, from 1998 to 2008, Hispanic and Asian individuals living in nursing homes increased more than 50 percent, and African-American people living in nursing homes increased by 10 percent.
The number of elderly in long-term care facilities is projected to grow dramatically. In fact, the U.S. Department of Health estimates that 70 percent of Americans over the age of 65 will require long-term care at some point.
If unaddressed, the quality of life gap is likely to increase.
“This gap is concerning. Minnesota is ranked first in the nation for quality of life and quality of care on the AARP scorecard for long-term care. If we’re seeing unmet needs here, that disparity is likely even greater throughout the country,” Shippee said.
“Thanks to CTSI and its commitment to advancing researchers’ careers, I could develop the expertise and connections I needed to be scored so highly on an R01 application as a junior investigator,” Shippee said.
It also opened opportunities for collaboration and allowed her the time to build relationships with the Minnesota Department of Human Services, which will partner with her on the project to work with nursing homes throughout the state.
“Nursing home residents’ quality of life – including their social connections, comfort, satisfaction with meals and sense of being treated with respect and dignity – is of paramount importance to the Minnesota Department of Human Services as a primary purchaser of nursing home services in the state,” said Bob Held, director of the DHS Nursing Facility Rates and Policy Division. “We are hopeful this project will help to ensure a high quality of life that is culturally and linguistically appropriate for all residents of Minnesota nursing homes.”
Valerie Cooke and Antonia Wilcoxon with the DHS will also collaborate on the study.
The team will interview residents, nursing home administrators and care providers about their experiences, attitudes, values and challenges within a long-term care setting. This qualitative data will allow them to evaluate and develop strategies for implementing change into the system to improve quality of life among all ethnic and racial groups. Qualitative findings will also inform further quantitative analyses both in Minnesota and nationally.
They will also reach out to community leaders and organizations to engage the surrounding neighbors and residents outside of the nursing homes.
“Our preliminary work showed nursing homes with a higher percentage of minority residents had lower quality of life scores, even when the majority of these facilities provided adequate quality of care. Yet most of these facilities were located in poorer neighborhoods, pointing to the likely relationship between place of residence and quality of life,” Shippee said.
Shippee hopes engaging with the community could integrate residents into the neighborhood and create a stronger sense of belonging.
“We need to acknowledge these disparities; just ignoring the issue won’t solve anything,” Shippee said. “By bringing everyone to the table, we can identify what’s contributing to this gap and make significant changes to improve the lives of our aging population.”