IDEAS home Printed from
   My bibliography  Save this article

Contextual determinants of US nursing home racial/ethnic diversity


  • Davis, Jullet A.
  • Weech-Maldonado, Robert
  • Lapane, Kate L.
  • Laberge, Alex


We hypothesized that for-profit/chain affiliated nursing homes, those in states with higher Medicaid reimbursement, and those in more competitive markets would have greater resident racial/ethnic diversity than nursing homes not meeting these criteria. Using 2004 Online Survey, Certification and Reporting data, Minimum Data Set, Lewis Mumford Center for Comparative Urban and Regional Research data, and the Area Resource File, we included U.S. Medicare/Medicaid certified nursing homes (N = 8950) located in 310 Metropolitan Statistical Areas. The dependent variable quantified facility-level multiracial diversity. Ordinary least squares regression showed support for the hypothesized relationships: for-profit/chain affiliated nursing homes were more diverse than nursing homes in all other ownership/chain member categories, while higher Medicaid per-diem rates, greater residential diversity, and stronger market competition were also positively associated with nursing home racial/ethnic composition. Results suggest there is room for policy changes to achieve equitable access to all levels of nursing home services for minority elders.

Suggested Citation

  • Davis, Jullet A. & Weech-Maldonado, Robert & Lapane, Kate L. & Laberge, Alex, 2014. "Contextual determinants of US nursing home racial/ethnic diversity," Social Science & Medicine, Elsevier, vol. 104(C), pages 142-147.
  • Handle: RePEc:eee:socmed:v:104:y:2014:i:c:p:142-147
    DOI: 10.1016/j.socscimed.2013.12.009

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Kris Knox & Eric Blankmeyer & J. Stutzman, 2006. "Private-Pay Demand for Nursing Facilities in a Market with Excess Capacity," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 34(1), pages 75-83, March.
    2. Rajiv Sethi & Rohini Somanathan, 2009. "Racial Inequality and Segregation Measures: Some Evidence from the 2000 Census," The Review of Black Political Economy, Springer;National Economic Association, vol. 36(2), pages 79-91, June.
    3. White, Halbert, 1980. "A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity," Econometrica, Econometric Society, vol. 48(4), pages 817-838, May.
    4. David C. Grabowski, 2004. "A Longitudinal Study of Medicaid Payment, Private-Pay Price and Nursing Home Quality," International Journal of Health Economics and Management, Springer, vol. 4(1), pages 5-26, March.
    5. Zinn, Jacqueline & Mor, Vincent & Feng, Zhanlian & Intrator, Orna, 2009. "Determinants of performance failure in the nursing home industry," Social Science & Medicine, Elsevier, vol. 68(5), pages 933-940, March.
    6. Sean Reardon & John Yun & Tamela Eitle, 2000. "The changing structure of school segregation: Measurement and evidence of multiracial metropolitan-area school segregation, 1989–1995," Demography, Springer;Population Association of America (PAA), vol. 37(3), pages 351-364, August.
    Full references (including those not matched with items on IDEAS)


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:104:y:2014:i:c:p:142-147. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.