The geography of the Long-term Care Continuum production system by county

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Jason C. Miller (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Keith Debbage

Abstract: The objective of this dissertation is to examine the fundamental geographic patterns at play regarding the spatial distribution of specific Aging in Place (AIP) and Aging in Community (AIC) opportunities in the United States by county, focusing on the characteristics of the workforce that provide these services. Secondly, this research aims to determine what are the key determinants or predictor variables that best explain this spatial distribution. This examination will investigate the geographical link between Facility-Based Services (FBS) and Home and Community-Based Services (HCBS), and their relationship to the older adult population. It is hypothesized that certain socio-economic and demographic variables that gauge culture, social capital, and prosperity will be instrumental in describing the geographic inventory of the Long-Term Care workforce and that specific establishments and initiatives dedicated to the Continuum of Long-Term Care are disproportionately located and clustered in these geographic areas. Specifically, it is hypothesized that the geography of Facility-Based and Home and Community-Based Services will vary and access to Long-Term Care will be unequal. The analysis revealed that Long-Term Care employment and Continuum of Care establishments are not evenly distributed throughout the United States, greatly influencing an individual’s ability to Age in Community. Urban counties, with higher population densities and elevated levels of social capital provide more HCBS and innovative Long-Term Care Options. Access barriers are accentuated in rural and less affluent geographies, often making institutionalized Skilled Nursing Homes the only available form of care.

Additional Information

Language: English
Date: 2017
Aging, Geography, Long-Term Care
Older people $x Long-term care $z United States
Health services accessibility $z United States
Medical anthropology $z United States
Social medicine $z United States
Economic geography

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