Prevalence of Pressure Ulcers by Race and Ethnicity for Older Adults Admitted to Nursing Homes

Abstract

Little is known about the prevalence of pressure ulcers among racial and ethnic groups of older individuals admitted to nursing homes (NHs). NHs admitting higher percentages of minority individuals may face resource challenges for groups presenting with more pressure ulcers or ones of greater severity. This study examined the prevalence of pressure ulcers (Stages 2-4) among older adults admitted to NHs by race and ethnicity at the individual, NH, and regional levels. Results show that the prevalence of pressure ulcers in Blacks admitted to NHs were greater than that in Hispanics, which were both greater than in Whites. The pressure ulcer rate among Black admissions was 1.7 times higher than Whites. A higher prevalence of pressure ulcers was observed among NHs with a lower percentage of White admissions.

Racial and ethnic disparities in the healing of pressure ulcers present at nursing home admission

“…A higher prevalence of pressure ulcers among Blacks compared to Whites (from 1% to 4% difference) has been observed in various cross-sections of NH residents (Cai, Mukamel, & Temkin-Greener, 2010; Lapane, Jesdale, & Zierler, 2005; Li, Yin, Cai, Temkin-Greener, & Mukamel, 2011). We are among those who have reported that the incidence of pressure ulcers is also greater among Black NH residents (Baumgarten et al, 2004; Harms et al, 2014; Rosen et al, 2006). The results of this study reveal that Black older adults with a pressure ulcer at NH admission are less likely to heal a pressure ulcer by the 90-day MDS assessment than would be expected had they been part of the White group.…”

“…Earlier reports reveal that more Blacks than Whites enter NHs with pressure ulcers and with more severe pressure ulcers (Baumgarten et al, 2004; Harms et al, 2014). A higher prevalence of pressure ulcers among Blacks compared to Whites (from 1% to 4% difference) has been observed in various cross-sections of NH residents (Cai, Mukamel, & Temkin-Greener, 2010; Lapane, Jesdale, & Zierler, 2005; Li, Yin, Cai, Temkin-Greener, & Mukamel, 2011).…”

“…Pressure ulcers among older individuals in long-term care facilities are a global problem with prevalence ranging from 10% to 30% (Ahn, Cowan, Garvan, Lyon, & Stechmiller, 2016; Bours, Halfens, Abu-Saad, & Gro, 2002; Capon, Pavoni, Mastromattei, & Di Lallo, 2007; Gunningberg, Hommel, Baath, & Idvall, 2013; Lahmann, Halfens, & Dassen, 2005; Levinson, 2014; Tannen, Bours, Halfens, & Dassen, 2006). The overall prevalence of Stage 2 to 4 pressure ulcers at NH admission in the United States (U.S.) ranges between 5%-20% (Baumgarten et al, 2004; Harms et al, 2014), but among minority NH admissions in the U.S., the prevalence is nearly twice that of Whites (Baumgarten et al, 2004; Harms et al, 2014). Braveman (2006) explains that a worse health or greater risk of worse health in groups systematically disadvantaged or discriminated against due to social factors such as race, ethnicity, poverty, sex, etc.…”

Pressure injuries in people with darker skin tones: A literature review

“…A consistent trend found across a number of the studies reviewed showed that people with DSTs had the highest risk of higher stages of PI (Ahn, Cowan, Garvan, Lyon, & Stechmiller, ; Baumgarten et al., ; Cai et al., ; Fogerty, Guy, Barbul, Nanney, & Abumrad, ; Gerardo et al. ; Harms et al., ; Li, Yin, Cai, Temkin‐Greener, & Mukamel, ; VanGilder, MacFarlane, & Meyer, ). Findings from one study suggested that people who had skin classified as medium or dark were more likely to develop PIs with a visible break in their skin (VanGilder et al., ).…”

“…This statement is reinforced by Harms et al. 's () study where people admitted to nursing homes who had been categorised as Black had a 1.7 higher chance of developing PIs than people categorised as White. Whilst PI risk amongst people with DSTs is high, the stage of PI varied; as drawing on further from Harms et al.…”