Geographic and racial inequalities in covid-19 outcomes in U.S. nursing homes
Abstract:
This study investigates the characteristics associated with covid-19 cases and deaths among U.S. nursing home residents from 2020-2021, with a focus on geospatial and racial inequalities. With data from the Centers for Medicare and Medicaid Services and LTCFocus, this paper uses zero-inflated negative binomial regression models, Kruskal-Wallis tests, and Moran’s I to generate statistical and geospatial results. Our analysis reveals that majority Hispanic facilities have alarmingly high covid-19 cases and deaths, and have the greatest need for policy improvements in staffing and financing to reduce racial inequalities in nursing home care. We also detect covid-19 hot spots in predominantly White, rural areas, indicating a need to rethink public messaging strategies in these regions. The top states with covid-19 hot spots are Kentucky, Pennsylvania, Illinois, and Oklahoma. This research provides new insights into the geographic contexts and structural inequities that contribute to the vulnerability of nursing home residents during a pandemic.