Health, Double Jeopardy, and Culture: The Use of Institutionalization by African-Americans

Abstract

Elderly African-Americans are admitted to nursing homes at between half and three-quarters of the rate of elderly whites. This review examines the theoretical approaches and the nature of the evidence typically brought to bear in addressing this issue. The double jeopardy hypothesis effectively describes but does not explain apparent racial inequities in the use of institutional care. Explanations based on the hypothesized African-American subculture will remain inadequate until they are grounded in data and take into account inequality.