Author: Travers, Jasmine L.; Agarwal, Mansi; Estrada, Leah V.; Dick, Andrew W.; Gracner, Tadeja; Wu, Bei; Stone, Patricia W.
Title: Assessment of COVID-19 Infection and Mortality Rates Among Nursing Homes with Different Proportions of Black Residents Cord-id: 6liqk9ut Document date: 2021_2_22
ID: 6liqk9ut
Snippet: Objective COVID-19 has disproportionately impacted nursing homes (NHs) with large shares of Black residents. We examined the associations between the proportion of Black residents in NHs and COVID-19 infections and deaths, accounting for structural bias (operationalized as county-level factors) and stratifying by urbanicity/rurality. Design This was a cross-sectional observational cohort study using publicly available data from the LTCfocus, Centers for Disease Control and Prevention (CDC) Long-
Document: Objective COVID-19 has disproportionately impacted nursing homes (NHs) with large shares of Black residents. We examined the associations between the proportion of Black residents in NHs and COVID-19 infections and deaths, accounting for structural bias (operationalized as county-level factors) and stratifying by urbanicity/rurality. Design This was a cross-sectional observational cohort study using publicly available data from the LTCfocus, Centers for Disease Control and Prevention (CDC) Long-Term Care Facility COVID-19 Module, and the NYTimes county-level COVID-19 database. Four multivariable linear regression models omitting and including facility characteristics, COVID-19 burden, and county-level fixed effects were estimated. Setting and Participants: 11,587 US NHs that reported data on COVID-19 to the CDC and had data in LTCfocus and NYTimes from January 20th, 2020 through July 19th, 2020. Measures Proportion of Black residents in NHs (exposure); COVID-19 infections and deaths (main outcomes). Results The proportion of Black residents in NHs were as follows: none= 3,639 (31.4%), <20%= 1,020 (8.8%), 20-49.9%= 1,586 (13.7%), ≥50= 681 (5.9%), not reported= 4,661 (40.2%). NHs with any Black residents showed significantly more COVID-19 infections and deaths than NHs with no Black residents. There were 13.6 percentage points more infections and 3.5 percentage points more deaths in NHs with ≥50% Black residents than in NHs with no Black residents (p<.001). While facility characteristics explained some of the differences found in multivariable analyses, county-level factors and rurality explained more of the differences. Conclusions and Implications It is likely that attributes of place, such as resources, services, and providers, important to equitable care and health outcomes are not readily available to counties where NHs have greater proportions of Black residents. Structural bias may underlie these inequities. It is imperative that support be provided to NHs that serve greater proportions of Black residents while considering the rurality of the NH setting.
Search related documents:
Co phrase search for related documents- Try single phrases listed below for: 1
Co phrase search for related documents, hyperlinks ordered by date