Assisted Living More Accessible to Well-Off

Assisted living facilities for older people are most often located in areas with higher levels of income, education, and home values, a new study shows. The results are published in Health Affairs.

These findings aren't surprising because private dollars have fueled the growth of assisted living facilities, the researchers wrote. However, the findings do mean that people with lower incomes, minorities, and those living in rural areas have fewer living options as they age.

"When we look at the distribution of the supply of assisted living facilities nationally, the assisted living facilities are distributed, in some respects, as you'd expect them to be," says study author David Stevenson, SM, PhD, an assistant professor of health policy at Harvard Medical School in Boston.

"These facilities tend to be located in higher socioeconomic areas—areas with more income, more education and fewer minorities," he explains.

In 2007, there were 11,276 assisted living facilities with a total of 839,746 residential units in the United States, according to the study. Connecticut, Hawaii, and West Virginia had fewer than 10 assisted living facilities per 1,000 elderly residents, while Minnesota, Oregon, and Virginia had more than 40 facilities per 1,000 older Americans, according to the study.

Other findings include the following:

• Household incomes were higher in areas with the highest penetration of assisted living facilities—$43,034 annually vs. $35,379 in areas with no assisted living.

• Average home values were $98,541 in areas with the most assisted living facilities compared with $69,560 in areas with no such facilities.

• College education rates were higher in areas with more assisted living facilities—almost 20% college-educated vs. 13.8% in areas without assisted living facilities.

• Areas without assisted living facilities were more likely to have a higher minority population—17.1% compared with 12.8% in the areas with more assisted living facilities.

• Urban counties were more likely than rural counties to have assisted living facilities.

• In areas with assisted living facilities, more people have long-term care insurance and more nursing home patients pay their own fees.

These findings are most useful from a public policy perspective, Stevenson says. "We need to keep in mind that the assisted living supply isn't distributed evenly, and that not all individuals would have access to assisted living even if public dollars were available to support it."

— Source: Brigham and Women's Hospital