{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T23:18:15Z","timestamp":1789600695911,"version":"build-2803163510"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K76AG074922"],"award-info":[{"award-number":["K76AG074922"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K76AG074926"],"award-info":[{"award-number":["K76AG074926"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG028747"],"award-info":[{"award-number":["P30AG028747"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001080","name":"Patrick and Catherine Weldon Donaghue Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001080","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Low nursing home staffing in the United States is a growing safety concern. Socioeconomic deprivation in the local areas surrounding a nursing home may be a barrier to improving staffing rates but has been poorly studied. Thus, the objective of this paper was to assess the relationship between neighborhood deprivation and nursing home staffing in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional study used 2018 daily payroll\u2010based staffing records and address data for 12,609 nursing homes in the United States linked with resident assessment data. Our primary exposure of interest was severe economic deprivation at the census block group (neighborhood) level, defined as an area deprivation index score \u226585\/100. The primary outcome was hours worked per resident\u2010day among nursing home employees providing direct resident care. Marginal linear regression models and generalized estimating equations with robust sandwich\u2010type standard errors were used to estimate associations between severe neighborhood deprivation and staffing rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to less deprived neighborhoods, unadjusted staffing rates in facilities located within severely deprived neighborhoods were 38% lower for physical and occupational therapists, 30% lower for registered nurses (RNs), and 5% lower for certified nursing assistants. No disparities in licensed practical nurse (LPN) staffing were observed. In models with state\u2010level and rurality fixed effects and clustered on the county, a similar pattern of disparities was observed. Specifically, RN staffing per 100 resident\u2010days was significantly lower in facilities located within severely deprived neighborhoods as compared to those in less deprived areas (mean difference: 5.6 fewer hours, 95% confidence interval [CI] 4.2\u20136.9). Disparities of lower magnitude were observed for other clinical disciplines except for LPNs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant staffing disparities were observed within facilities located in severely deprived neighborhoods. Targeted interventions, including workforce recruitment and retention efforts, may be needed to improve staffing levels for nursing homes in deprived neighborhoods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.17990","type":"journal-article","created":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T06:58:34Z","timestamp":1659941914000},"page":"711-719","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Severe neighborhood deprivation and nursing home staffing in the United States"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9063-0617","authenticated-orcid":false,"given":"Jason R.","family":"Falvey","sequence":"first","affiliation":[{"name":"Department of Physical Therapy and Rehabilitation Science, Department of Epidemiology and Public Health University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erinn M.","family":"Hade","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Population Health New York University Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Population Health New York University Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Epidemiology NYU School of Global Public Health  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management NYU Robert F. Wagner Graduate School of Public Service  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn I.","family":"Stone","sequence":"additional","affiliation":[{"name":"LeadingAge  Washington District of Columbia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine L.","family":"Travers","sequence":"additional","affiliation":[{"name":"New York University Rory Meyers College of Nursing  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,8]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"National Center for Health Statistics.Nursing home care. Retrieved February 22 2022.https:\/\/www.cdc.gov\/nchs\/fastats\/nursing-home-care.htm."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1178632920934785"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnr050"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/08959420.2020.1824544"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2019.02.002"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly089"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnw193"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12142"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2018.05.017"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12801"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2021.04.005"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/M13-2946"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2021.01289"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.0422"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2020.00957"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001888-200412000-00004"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2019.00952"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17678"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.20571"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/48.Supplement_1.71"},{"key":"e_1_2_11_22_1","article-title":"Does transport help people to gain employment? 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