RWJF Content Alert - In Many Regions, Assisted Living Options are Needed, but Not Found

Publication Date: 
January 5, 2010

In Many Regions, Assisted Living Options are Needed, but Not Found - Study Shows Assisted Living Facilities Are More Prevalent in Areas With Higher Income, Education Levels

A new report prepared by researchers at Harvard Medical School shows that where seniors live plays a large role in their access to assisted living facilities. Researchers show that assisted living facilities are disproportionately located in areas where people are wealthier and better educated, and where home values are higher—leaving low-income people, minorities, and people living in rural areas with relatively little access to housing and long-term care options.

The authors find that the growth in assisted living has been largely fueled with private dollars, which is reflected in the distribution of facilities nationally, causing wide variation in access from state to state. Minnesota, Oregon, and Virginia have the highest rate of facilities, with more than 40 facilities per 1,000 people aged 65 and older. Connecticut, Hawaii, and West Virginia have the lowest, with fewer than 10 facilities per 1,000 elderly people.

Findings include:

  • Counties with no assisted living options have lower rates of people who had a college education (13.8 percent) than counties with the highest penetration of assisted living facilities (where almost 20 percent of residents have a college education).
  • Compared to locations with the highest penetration of assisted living options, median household incomes are lower in areas with no assisted living facilities ($35,379 versus $43,034), as are median home values ($69,560 versus $98,541). 
  • Counties without assisted living options are likely to have more minorities (17.1 percent versus 12.8 percent) than counties with more facilities.
    Rural counties are more likely to lack an assisted living facility.

The paper was funded by the Robert Wood Johnson Foundation’s Changes in Health Care Financing and Organization (HCFO) program, and is one of a series of articles related to long-term care featured in this month’s edition of Health Affairs.

Read the article.