A research project in development at Brown University will evaluate the impacts of market forces and public policies on care for older Americans. One specific aim is to examine how residential segregation affects the provision of nursing home services. Prior research has documented the existence of different "tiers" of nursing home care that are related to poverty, a predominance of Medicaid supported residents and a disproportionate share of African American residents. This study seeks to identify the extent to which neighborhood segregation is associated with residential segregation in the nursing home which, in turn, is related to the quality of care provided to residents. PI of this portion of the project is Mary Fennell (Department of Sociology).

This webpage illustrates the phenomenon in the State of Georgia, and demonstrates how web-based GIS systems can be used to disseminate information about residential patterns and the location and quality of nursing homes. A similar system will be developed to cover the entire United States.

On the following page, use the map tools (located at the top of the screen) to zoom in and out, pan, and obtain information about specific neighborhoods and nursing homes. The HELP button provides instructions on these tools. Here is an example of a simple session:

1. Use the menus on the upper left to choose neighborhood data (for census tracts in 2000) to show on the map. For example, choose percent black. Map colors now reflect racial composition of the areas for the whole state.
2. Click on the "zoom in" tool [] on the toolbar. Now use your cursor to draw a rectangle around an area that includes not more than 20 counties. At this zoom level, you will be able to see the location of nursing homes. The legend shows how the homes' racial composition and quality are displayed by color. You can zoom in further to show locations in more detail. You can turn on the "major roads" layer (on the left side of the screen) for better orientation, and if you zoom in sufficiently, you can turn on the "local streets" layer. (Click on "refresh map" to execute these changes.)
3. Click on the "HYPERLINK" tool [] on the toolbar. Now move your cursor on top of a nursing home and click. A pop-up window will give detailed information about this nursing home, including its name, residents, and several indicators of quality. Be sure to turn off the pop-up blocker on your browser. Overall quality (displayed on the map) is based on number of reported deficiencies in the OSCAR reporting network, dividing Georgia's nursing homes in quartiles from worst to best.