Nursing homes have been disproportionately impacted by COVID-19. The purpose of this study was to examine whether there were racial, ethnic, and socioeconomic differences in COVID-19 infection and mortality rates at both the nursing home resident and nursing home facility levels. The study includes national data on COVID-19 outcomes for nursing home residents through the end of June 2021. This study found that residents identifying as Black, Hispanic, Asian, or Native American had higher rates of COVID-19 diagnosis and mortality than White residents even after adjusting for risk factors such as comorbid conditions; individual level race, however, was no longer statistically significant after accounting for other nursing home and county characteristics. The study also found that facilities with a higher proportion of Black and Hispanic residents were significantly associated with greater likelihood of COVID-19 diagnosis; residents of facilities with a higher percentage of residents with Medicaid as the primary payer tended to have higher rates of COVID-19 diagnosis and mortality; and, greater county-level socioeconomic social vulnerability was associated with higher rates of COVID-19 diagnosis and mortality, although controlling for other variables of interest attenuated these relationships.
This research was conducted under contract #HHSP233201500050I between HHS/ASPE’s Office of Behavioral Health, Disability, and Aging Policy (BHDAP), and RTI International and Acumen. Additional research in this area is available at the ASPE Aging & Disability page.
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