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Addressing Systemic Racism in Nursing Homes: A Time for Action
Philip D Sloane1, Ruqaiijah Yearby2, R Tamara Konetzka3
1Cecil G. Sheps Center for Health Services Research and Departments of Family Medicine and Internal Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Journal of the American Medical Directors Association
|March 29, 2021
Summary
Racial disparities in US long-term care access and outcomes are rooted in systemic racism. Addressing these requires dismantling racist structures within the long-term care system.
Area of Science:
- Public Health
- Sociology of Health and Illness
- Gerontology
Background:
- The US long-term care system for older adults is characterized by significant racial segregation and disparities.
- These inequities in access, care processes, and health outcomes have been exacerbated by the Coronavirus Disease 2019 pandemic.
Purpose of the Study:
- To examine the role of systemic racism in perpetuating racial disparities within the US long-term care system.
- To identify mechanisms through which racism impacts care access and outcomes for older persons.
Main Methods:
- Analysis of the structural, interpersonal, and cultural dimensions of racism within the long-term care sector.
- Examination of how geographical segregation, fragmented payment systems, and undervaluation of care workers contribute to disparities.
Main Results:
- Systemic racism is a fundamental driver of racial disparities in long-term care access, process, and outcomes.
- Residential segregation, financial barriers, and inadequate worker reimbursement policies are key mechanisms perpetuating these inequities.
Conclusions:
- Eliminating racial disparities in long-term care necessitates a comprehensive strategy to address systemic racism.
- Policy and practice changes must target the foundational drivers of inequity to improve health outcomes for all older persons.
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