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New health equity review reveals care-related disparities for minorities in long-term care


A new systematic review analyzing care outcomes in long-term care, found 62% of included studies demonstrated disparities in care outcomes for minoritized groups compared to majority groups in long-term care, as published in Age and Ageing, the official journal of the British Geriatrics Society.

“To tackle health inequity, we need research that considers the intersecting factors driving disparities,” said Mary Scott, Epidemiologist at the Public Health Agency of Canada, Research Associate at The Ottawa Hospital, and lead author of the study conducted at Bruyère Research Institute. “This research summarized inequities at the individual, provider, and health system level to describe their influence on clinical and care outcomes for minoritized residents.”

Minority status was assessed not only as race and ethnicity, but included cultural, religious, linguistic, and sexual and gender identity in the context of the dominant population.

Ninety-one percent of reviewed studies revealed existing differences upon entry to long-term care homes, where minoritized populations were already experiencing outcome disparities compared to majority populations that remained or worsened over time. Sixty-two percent of studies in the review demonstrated significant differences in care-related outcomes between minoritized and dominant populations, even after controlling for confounding factors.

In addition to baseline differences, health care system-level factors were found to negatively impact the care outcomes for minoritized populations. Some studies pointed to a lack of uniformity in the quality of care across homes, finding larger proportions of minoritized populations were living in homes with lower standards of care. Systemic disparities in long-term care outcomes for minoritized populations highlight the need for comprehensive research to inform equitable policies and practices.

The review is the first to synthesize evidence on the care experiences and outcomes of individuals living in long-term care, yet researchers at Bruyère caution there is still a lack of evidence.

Building evidence to advance health equity: a systematic review on care-related outcomes for older, minoritized populations in long-term care homes was published in Age and Ageing.


The Official Language Community Development Bureau at Health Canada commissioned this review to inform the national standards. The sponsor had no role in the design of the study; synthesis, analysis or interpretation of the data; or approval of the manuscript. This work was undertaken when author (M. Scott) was working at Bruyère Research Institute and does not reflect the position of the Public Health Agency of Canada.