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October 8, 2025Journal of Aging & Social PolicyOpen Access

Racial and Ethnic Inequities in the Relationship Between State Home and Community-Based Services Expenditures and Long-Term Care Utilization in the United States: A Fixed-Effects Analysis

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Authors

ALA. LeeYYYulin YangTRThomas Rapp

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Overview

Fixed-effects analysis shows inequities in HCBS funding benefits for older adults, suggesting that Black and Hispanic groups utilize LTSS less distinctly compared to Whites.

Key Points

  • Higher state-level HCBS spending positively influenced home health care use among non-Hispanic White older adults, indicating disparities exist in LTC utilization.
  • The study analyzed HCBS expenditures from 1996 to 2016, revealing systemic inequities affecting Black and Hispanic older adults' access to LTSS.
  • Multivariate logit models were used to assess the impact of state expenditures, accounting for socio-demographic and time effects among 3,097 Medicaid beneficiaries.
  • The findings highlight a need for further exploration into structural barriers affecting LTSS access, particularly for racial and ethnic minorities.

Cite This Study

Lee et al. (2025) studied this question.

synapsesocial.com/papers/68e5c1b46950a706b22b5180https://doi.org/10.1080/08959420.2025.2568430
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