Nursing homes caring for mostly minorities twice as likely to have COVID-19 outbreaks
The novel coronavirus has long preyed on older adults for their weakened ability to fight off microbial threats, but as more case and death data are released, problems rooted deep in systemic inequality are coming to light faster than ever before.
Now, a new analysis reveals that nursing homes with predominantly minority, nonwhite residents are more than twice as likely to house coronavirus cases and deaths than homes with mostly white residents.
The research was discussed last week during a hearing with the Senate’s Special Committee on Aging in a session called “Caring for Seniors Amid the COVID-19 Crisis.”
“The patterns of infections and deaths are not random,” Dr. Tamara Konetzka, a professor of health services research at the University of Chicago who conducted the analysis, said in her submitted testimony to the Senate.
“Consistent with racial and socioeconomic disparities in long-term care historically and in pandemic-related deaths currently, nursing homes with traditionally underserved populations are bearing the worst outcomes,” she added.
About eight out of every 10 coronavirus deaths reported in the U.S. have been adults 65 years of age and older, according to the Centers for Disease Control and Prevention.
Older adults are known to have naturally weaker immune systems than their younger counterparts, and they tend to have more underlying health conditions such as cancer, diabetes and high blood pressure as a result, making them more susceptible to coronavirus infection, experts say.
What’s more, understaffed nursing homes have all these vulnerable individuals who need hourly hands-on care housed together, making social distancing nearly impossible and viral spread inevitable.
When looked at it this way, the numbers make sense, but Konetzka wondered if some nursing homes were simply able to better manage themselves than others.
Nursing homes with nonwhite residents more vulnerable
Konetzka worked with Rebecca Gorges, a doctoral student at the Harris School of Public Policy at UChicago, to study coronavirus cases from 5,527 nursing homes and death data from 3,461 nursing homes in 12 different states including California, Colorado and Georgia, according to the testimony.
The pair studied the homes’ “star ratings,” status as for profit or nonprofit and resident characteristics.
The researchers found that “nursing homes with the lowest percent of white residents were more than twice as likely to have COVID-19 cases or deaths as those with the highest percent white residents,” the testimony said.
The results showed “only a marginally lower probability of cases” for homes with higher star ratings, and no differences in COVID-19 cases between profit and nonprofit homes.
And because people want to stay as close to home as possible, the nursing homes individuals live in are “often a reflection of the neighborhoods” they are located in, Konetzka said.
Therefore, there is a “strong and consistent relationship between race and the probability of COVID-19 cases and deaths,” the testimony said.
Minorities have long suffered from health disparities, injustice
A Washington Post analysis found similar results in minority populations outside of nursing homes.
“Majority of black counties have three times the rate of infections and nearly six times the rate of deaths as majority white counties,” the analysis said.
One reason is that black Americans tend to have higher rates of underlying health conditions and less access to healthcare.
A 2014 study showed that hospitals in predominantly black neighborhoods were more likely to shut down than those in whiter areas.
A woman, who says she is a nurse in New York, took to social media to express her frustrations over her hospital’s handling of minority patients, claiming “[staff] are gonna let them rot on the bed; they are medically mismanaging these patients.”
The nurse goes on to explain several scenarios of “gross negligence” that have left minorities dead on their beds for unknown amounts of time, and says that no one cares to help them.
“Literally, black lives don’t matter here,” the nurse said in tears.
The Washington Post analysis also mentioned that black people are more likely to have “essential” jobs such as in the hotel and food industry that make them more vulnerable to community coronavirus spread.
Another longtime issue has been housing disparities among minorities who are more likely to live in densely packed neighborhoods with multiple families, an environment that can more easily facilitate viral spread.
A 2017 study from Princeton University discovered that black children living in older buildings infested with rodent droppings and near air-polluted highways are more likely to suffer from asthma.
A separate NPR analysis looked at 78 nursing homes in New York and found that seven of the 11 homes with the highest number of deaths had 46% or more residents of color— black or latinx.
Konetzka proposed that regular and rapid testing is needed for all nursing home staff and residents in order to help curb COVID-19 spread. She also said staff must be adequately numbered and provided with appropriate and sufficient personal protective equipment.
“Health disparities have always existed for the African American community,” Dr. Anthony Fauci, leading epidemiologist in the White House coronavirus task force, said in April, according to the Washington Post.
“But here again with the crisis now — it’s shining a bright light on how unacceptable that is.”
This story was originally published May 27, 2020 at 10:27 AM with the headline "Nursing homes caring for mostly minorities twice as likely to have COVID-19 outbreaks."
