# BLACK-WHITE DIFFERENCES IN THE USE OF LONG-TERM CARE

> **NIH NIH R01** · RAND CORPORATION · 1992 · $121,490

## Abstract

The pattern of use of long-term care services among African-American
elderly differs from that of white Americans.  Most notably,
African-Americans are significantly under-represented in nursing homes.
No studies have sufficiently assessed the extent to which these
differences are due to differences in socioeconomic status or other
independent factors.  Furthermore, no studies have demonstrated the
impact of this difference in the use of long-term care services on the
survival of black elderly.  This study will analyze the differences
between black and non-Hispanic white elderly in their patterns of use of
long-term care services after they become significantly impaired.  It
will focus on the contribution of socio-economic factors to these
observed black-white differences and the relationship between the types
of long-term care services used and survival.  The analysis will be based
on an economic model which integrates the determinants of three sets of
long-term care outcomes: 1) living arrangements, 2) use of community
long-term care services, and 3) mortality.  This economic model will
serve as a framework for understanding the behavior of families in
response to significant functional impairment in a parent and the
relationship of this response to mortality.  It will provide an economic
perspective to understanding the relative role of race as a proxy for
socio-economic status in the use of long-term care services.  Household
and family size and composition, financial resources, and opportunity
costs will be studied as potential factors explaining the different
patterns in the use of long-term care services for black and white
elderly.  We will estimate equations for the hazard of nursing home
entry, the choice of community living arrangements, the use of community
long-term care services, and the mortality of a population of elderly
parents of respondents to the Panel Survey of Income Dynamics.  The
effects of race will be assessed by the comparison of two analytic
approaches.  First, we will model the effect of race by entering race as
a dummy variable in the equations for each outcome.  Second, we will
estimate separate equations for blacks and whites and compare the
patterns of significant explanatory variables in the two sets of
equations.  Statistical techniques will correct for the competing risks
of death and nursing home admission and the non-random selection of
parents who become significantly impaired.

## Key facts

- **NIH application ID:** 3123168
- **Project number:** 1R01AG011175-01
- **Recipient organization:** RAND CORPORATION
- **SAM.gov UEI:** YY46Q97AEZA8
- **Principal Investigator:** RAYNARD S. KINGTON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1992
- **Award amount:** $121,490
- **Award type:** 1
- **Project period:** 1992-09-30 → 1994-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/3123168

## Citation

> US National Institutes of Health, RePORTER application 3123168, BLACK-WHITE DIFFERENCES IN THE USE OF LONG-TERM CARE (1R01AG011175-01). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/3123168. Licensed CC0.

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