Racial and Gender Differences in Pressure Ulcer Development Among Nursing Home Residents in the Southeastern United States

Abstract

Objective: To determine whether there is a difference in the incidence of pressure ulcers (PU) between African American (AA) and White nursing home (NH) residents in the Southeastern United States. Methods: Data from the Centers for Medicare and Medicaid Services Minimum Data Set were examined for 113,869 residents who were free of PU at NH admission during 1999–2002. Facility and neighborhood characteristics were abstracted from the Online Survey Certification and Reporting database and the 2000 U.S. Census respectively. Results: The incidence of PU in NH among AAs and Whites was 4.7% (95% CI: 4.4–5.0) and 3.4 % (95% CI: 3.3–3.5) respectively. The association between race and PU development varied between males and females. Differences were noted between AA and White males who were dependent in mobility and between AA and White females who were bedfast and resided in facilities with less than 200 beds. Unlike for females, facility and neighborhood characteristics were not significant confounders in risk for PU incidence among males. Conclusion: PU occurred more frequently in AAs than in Whites. Results suggest that racial differences are marked among males and females with specific characteristics. Interventions for reducing this disparity should target these at-risk groups.

KEYWORDS:

• pressure ulcer
• decubitus ulcer
• nursing homes
• African Americans
• racial disparity

ACKNOWLEDGEMENTS

This research was funded by the DHHS, Agency for Healthcare Research and Quality, grant R24 HS013353. Investigators were supported in part by the National Institute of Health, National Center on Minority Health and Health Disparities, grant P20 MD003939. This research was funded in part by NIH National Center for Research Resources, Extramural Research Facility Improvement Program grant C06 RR20139.

This paper was presented in poster form at the November 18–22, 2005, meeting of the Gerontological Society of America in Orlando, Florida.