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50+: Live Better, Longer

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Wealthy Areas Attract Assisted-Living Homes

Study Shows Assisted-Living Facilities Are Concentrated in High-Income Counties
By Caroline Wilbert
WebMD Health News
Reviewed by Louise Chang, MD

Jan. 5, 2010 -- Assisted-living facilities are more likely to be located in wealthier neighborhoods, according a new analysis published in Health Affairs.

Researchers compared the penetration of assisted-living facilities nationally with county data from 2007 on education, median household income and other economic indicators, and racial composition. Findings include:

  • The median household income in counties without assisted-living facilities was $35,379, compared with $43,034 in counties with the highest penetration of assisted-living facilities.
  • The median home value in counties without facilities was $69,560. That compares to $98,541 in counties with the highest penetration of facilities.
  • In counties without assisted-living facilities, just 13.8% of people have a college education. By contrast, in counties with the highest penetration of facilities, nearly 20% of people have college degrees.
  • Rural counties are less likely to have an assisted-living facility than urban counties.
  • Minorities make up 17.1% of the population in counties without assisted-living facilities. Counties with the highest penetration of facilities have 12.8% minorities.

Assisted-living facilities have become more widespread in recent years. The authors cite an estimate of 38,000 assisted-living facilities and 975,000 units (a unit may contain more than one bed) in the U.S. in 2007.

While nursing homes are heavily regulated and rely on public money (Medicaid pays about half the nation's nursing home bill) there is little government involvement in assisted living. If this changes, the access-to-care issue will need to be tackled by policy makers, the authors say.

"The growth of assisted living has been fueled mostly with private dollars, and the distribution of facilities nationally reflects this fact," study researcher David Stevenson, an assistant professor of health policy at Harvard Medical School, says in a news release. "States have been cautious to date in expanding Medicaid coverage for care in assisted living. If this changes in the future and more public dollars flow into this sector, however, policymakers will have to address important issues related to access to services, financing, and oversight of care."

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