Assisted living and special populations: what do we know about differences in use and potential access barriers?
OBJECTIVE
The purpose of this article was to review existing knowledge about assisted living (AL) use by traditionally underserved populations, including people of color, low-income people, and those living in rural communities.


METHODS
We reviewed methodologies and findings of research on AL and residential care up to June 2004.


RESULTS
Some studies suggested that low-income people and people of color either are less likely to utilize AL or receive AL in settings with less space and amenities and/or lower scores in selected quality measures. Generalizations from national or multistate studies to the population have methodological limitations. Numerous topics remain unstudied, including the pricing of AL, the experience of choosing an AL facility, the presence of discriminatory admission and retention practices, and the role of resident preferences. Data on access to AL in rural areas are inconclusive.


CONCLUSIONS
We offer recommendations for national surveys to better classify supportive housing settings. Furthermore, we suggest quantitative and qualitative studies to illuminate the experience of low-income, racial/ethnic minority, and rural populations in AL settings.
Hernandez
Mauro
M
Department of Social and Behavioral Sciences, University of California, San Francisco, 3333 California Street, Suite 455, San Francisco, CA 94118, USA. mauro.hernandez@ucsf.edu
Newcomer
Robert
R
D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000375:Aging; D040561:Assisted Living Facilities / Q000706:statistics & numerical data*; D019538:Health Care Surveys / Q000379:methods; D006297:Health Services Accessibility / Q000592:standards* / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D011203:Poverty / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D011287:Prejudice; D036301:Qualitative Research; D012107:Research Design; D012114:Residential Treatment; D019035:Rural Health Services / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology