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Daniel L. Howard, PhD, Philip D. Sloane, MD, MPH, Sheryl Zimmerman, PhD, J. Kevin Eckert, PhD, Joan F. Walsh, PhD, Verita C. Buie, MS, Persephone J. Taylor, BS and Gary G. Koch, PhD

Daniel L. Howard and Persephone J. Taylor are with the Department of Natural and Physical Sciences, Environmental Science Program, Shaw University, Raleigh, NC. Philip D. Sloane is with the Department of Family Medicine and Sheryl Zimmerman is with the School of Social Work, and both are with the Program on Aging, Disability, and Long-Term Care of the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill. J. Kevin Eckert is with the Department of Sociology and Anthropology at the University of Maryland, Baltimore County. Verita C. Buie is with the Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore. At the time of the study, Joan Walsh was with the Aging, Disability, and Long-Term Care Program, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill. Gary G. Koch is with the Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill.

Correspondence: Requests for reprints should be sent to Philip Sloane, MD, MPH, 725 Airport Rd, CB 7590, Chapel Hill, NC 27599–7590 (e-mail: psloane{at}med.unc.edu).

Objectives. In this study, we examined racial separation in long-term care.

Methods. We used a survey of a stratified sample of 181 residential care/assisted living (RC/AL) facilities and 39 nursing homes in 4 states.

Results. Most African Americans resided in nursing homes and smaller RC/AL facilities and tended to be concentrated in a few predominantly African American facilities, whereas the vast majority of Whites resided in predominantly White facilities. Facilities housing African Americans tended to be located in rural, nonpoor, African American communities, to admit individuals with mental retardation and difficulty in ambulating, and to have lower ratings of cleanliness/maintenance and lighting.

Conclusions. These racial disparities may result from economic factors, exclusionary practices, or resident choice. Whether separation relates to inequities in care is undetermined. (Am J Public Health. 2002;92:1272–1277)

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