New study: Disability and income prevent Black Americans from aging at home

We all have to face the prospect of aging at some point. We prepare for this reality for years in advance, starting 401ks, contributing to Medicare and Social Security as well as comparing insurance plans.

For many Americans, the goal is to have ample healthcare, a nest egg to retire on and the ability to age peacefully at home.

According to a new survey conducted between January and February of 2022, however, these goals are not being equally obtained by all. Conducted with 2,227 random Americans aged 50 to 80 online or via phone, the survey found that Black citizens were less likely to achieve aging in place.

This is thanks to a variety of factors, with the two most significant being self-reported disability status and income.

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Black Americans face barriers to aging at home

Led by Sheria Robinson-Lane, assistant professor in the department of systems, populations and leadership with the University of Michigan's School of Nursing in Ann Arbor, the study published Oct. 4 in journal Geriatric Nursing found that nearly one third of adults aged 50–80 (30.9%) reported currently living with a disability.

Black adults experienced the highest rate of disability at 40% as well as higher rates of "fair" or "poor" physical health at 37.1% versus 20.9% overall.

Black households were also more likely to report having a family member with a disability present with 36.4% compared to the overall sample of 23.3%. Half of Black households also reported an income lower than $30,000 a year, a significant discrepancy from the quarter of overall respondents who reported the same thing (23.3%).

Older Black Americans are also more likely to live alone, with 44.1% reporting they were the only one in their home versus a quarter of overall respondents. This, paired with the aforementioned factors, cumulate in Black adults having lower rates of confidence in their ability to afford and find necessary in-home care.

How does all of this prevent Black Americans from aging at home? First and foremost, said the study's authors, increased rates of disability mean more strain on already thinly stretched resources.

Older adults with disabilities often require some form of assistive device, human support or other accommodations. The U.S. Department of Health & Human Services' Administration on Aging found that on average, 70% of people 65 and up need some type of long-term care, such as a nursing home or assisted living, at some point, while 20% will need that care for more than five years.

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Cost of care disproportionality impacts aging Americans of color

With assisted living costs averaging at $4,500 per month and nursing homes averaging $7,908-$9,034 per month for a semi-private room or private room according to Genworth Financial's 2021 Cost of Care Survey, support for older people is in no way cheap.

In-home care is pricey as well, with median prices hovering between $4,957 to $5,148 per month for homemaker services or a home health aide, according to the same 2021 data. In the same year, more than half of Americans had less than $250 left at the end of the month after paying necessary bills.

With older Black Americans more likely to shoulder the weight of higher healthcare costs due to disability, more likely to live alone without in-home familial assistance and more likely to grapple with an income under $30,000, they face multiple barriers to aging in their own home and communities.

Within the overall sample, 41.3% of respondents were not confident they could afford supportive care such as assistance with chores, shopping, personal care or finance management if needed. Facing down the existing cost-of-living crisis, many older Americans have found themselves without means to live comfortably or access necessary resources.

In an already difficult fiscal climate, ethnic and racial discrepancies continue to impact quality of care for our older population. According to the study's authors, healthcare facilities placing a focus on adapting and optimizing care to close these gaps is an important course of action to begin addressing the disparity.

"Aging in place requires a proactive individual and community-based approach that facilitates older adult independence and connects adults with the social, clinical, and environmental support needed to remain in one's home for as long as possible," the study said.