McKnight's Long-Term Care News, April 2019, page 10, Nursing

The pandemic is forcing long-term care leaders and operators to address and help alleviate racial disparities often found and perpetuated throughout the healthcare industry, a well-known academic and leader said Wednesday during a long-term care summit. 

“When we think about the most vulnerable in our population right now, we are talking often about people of color, older citizens, and we’re talking about [their] needs, figuring out ways to have better practices and better policies,” said Freeman Hrabowski II, president of the University of Maryland, Baltimore Country. 

“When we look at COVID … we see a light shining on what’s happening to senior citizens but also first-line workers,” Hrabowski added. 

Hrabowski’s comments came during a virtual summit Wednesday hosted by the Advancing Excellence in Long-Term Care Collaborative. The summit, which continues through Friday, addresses racial inequalities experienced by workers and residents in long-term care. 

Difficult conversations

Hrabowski stressed that long-term care advocates and leaders must look at different practices, be willing to listen, place an emphasis on diversity at all organizational levels, learn from their biases, and listen to the concerns of their workers by having difficult conversations about race. 

“I want to challenge you to watch thoughts [which] become your words, your words become your actions, your actions become your habits, your habits become your character, and your character becomes your destiny. This is the time for moral leadership, for values and actions,” he said during the opening keynote address. 

Healthcare segregation

Harvard professor and health policy expert David Grabowski, Ph.D., noted during the welcome session of the summit Monday that research over the last several years has shown that nursing homes are typically more segregated than hospitals. Research also shows that Black and Hispanic nursing home residents are more likely to enter facilities that have more deficiencies and substantially understaffed. 

“This is the kind of disparities that we’re really concerned about. Black and white nursing home residents enter very different types of facilities and, once again, that’s very reflective of the segregation I mentioned earlier,” Grabowski said. 

A recent Harvard analysis found that nursing homes that are larger and have more Black residents are at an increased risk of having COVID-19 cases. A separate study found that nursing homes whose workers who live in less white and denser areas have higher numbers of coronavirus cases and deaths. 

“This is a topic we’ve long ignored in nursing homes and long-term care,” he explained. “COVID has really brought this issue, like other issues, to the surface. We know there’s been issues with workforce, and issues with payment and I think racial and ethnic disparities is another issue that has been magnified and exacerbated by COVID.”