Related Experiment Video
Updated: Sep 16, 2025
Using the Race Model Inequality to Quantify Behavioral Multisensory Integration Effects
Published on: May 10, 2019
Black-White Differences in Long-Term Services and Supports (LTSS) Deserts: Implications for Unmet Care Needs
Chanee Fabius1, Kali S Thomas2, Jennifer C Cornman3
1Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Objectives:
Little is known about the impacts of living in a long-term services and supports (LTSS) "desert," where there are few community-based care options. We sought to understand whether racial disparities exist in LTSS availability and variety and associations with unmet care needs for non-Hispanic White and Black older adults.
Design:
Cross-sectional study of national survey data linked to contextual LTSS market measures.
Setting And Participants:
Non-Hispanic White (n = 1751) and Black (n = 603) adults aged 70 and older with activity limitations from the 2019 National Health and Aging Trends Study (NHATS).
Methods:
The outcome of interest is any adverse consequence as the result of unmet care needs for household, self-care, or mobility activities. We estimate multivariable logistic regression models adjusting for a novel measure reflecting LTSS availability and variety (fertile, typical, desert), consisting of the number of home health agencies, residential care/assisted living beds, and adult day care providers in a county per 100,000 older adults.
Results:
Relative to White older adults, Black older adults more often experienced adverse consequences due to unmet need (35.0% vs 27.6%, P < .03). Although not statistically significant, older Black adults were more likely to live in an LTSS desert (P < .058). In fully adjusted within-group multivariable logistic regression models, living in an LTSS desert was associated with greater odds of experiencing adverse consequences due to unmet need among White, but not Black, older adults (adjusted odds ratio, 1.50; 95% CI, 0.95-2.36). For both White and Black older adults, single older adults and those receiving unpaid or paid community-based care were more likely to experience adverse consequences due to unmet need.
Conclusions And Implications:
Findings underscore differences in how LTSS availability and variety relate to unmet care needs for Black and White older adults. Future research should examine these associations in other racial and ethnic minoritized groups.
More Related Videos
Related Concept Videos
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:25Continuing Care
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:29Issues And Trends In Healthcare Delivery System
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...