Poor Communities Have Worse Staffing.

• Position: NURSING HOMES

Nursing homes located in disadvantaged neighborhoods are staffed for fewer hours by clinical workers, such as registered nurses and physical therapists, compared with those in more well-off areas, a disparity that could compromise the safety of residents, according to research published in the Journal of the American Geriatrics Society.

"Nursing home staffing in the U.S. is a growing safety concern, one that has been exacerbated by the COVID-19 pandemic," says senior author Jasmine Travers, assistant professor at New York University's College of Nursing.

Most skilled nursing facilities are already concerned about low staff-to-resident ratios, but our analysis reveals that this gap is even worse in disadvantaged communities.

Residents in nursing homes often have complex medical needs, and research shows that nursing homes with higher levels of staffing have better outcomes. Greater staffing by registered nurses, in particular, is associated with lower rates of infection and mortality.

While nursing homes in disadvantaged neighborhoods are more likely to serve vulnerable populations of older adults, including racial and ethnic minorities, less is known about how a neighborhood's socioeconomic factors influence staffing. Prior research often has relied on poverty as a single socioeconomic indicator and used data by county or zip code, which does not take into account neighborhood-level differences.

Using area deprivation index scores, 16% of nursing homes in the study were found to be in...