New Data Shows Racial and Ethnic Disparities for Medicare Beneficiaries Who Have Difficulty with Activities of Daily Living

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AUTHOR – ATI Advisory


PRINCETON, N.J. and WASHINGTON, D.C. Sept. 14, 2023 /PRNewswire/ – Community-dwelling Medicare beneficiaries who are Black and/or Latino/a are more likely than white beneficiaries to report difficulty managing activities of daily living, according to a databook released by ATI Advisory (ATI) with support from the Robert Wood Johnson Foundation (RWJF). Activities of daily living include dressing, bathing, walking across the room, transferring in and out of bed or chair, using the toilet, and eating.

Not only are Black and/or Latino/a beneficiaries more likely to report activity of daily living difficulty, but they are also more likely to lack important resources available to manage their care.

Black and/or Latino/a beneficiaries reporting difficulty with activities of daily living are more likely than white beneficiaries to report low incomes, food insecurity, and low rates of high school graduation, and less likely to report being married, all of which impact their experience with accessing long-term services and supports. Black beneficiaries are more likely to report problems paying medical bills.

Caregivers of Black and/or Latino/a beneficiaries reporting difficulty with activities of daily living are more likely to be younger than 65 and be a non-spousal female relative compared to caregivers of white beneficiaries. Often caregiving involves personal and financial obligations, especially for young female relatives who may be in the workforce or must leave the workforce.

“These findings point to the need for policy solutions and targeted interventions to address inequities in access to long-term services and supports,” said Katherine Hempstead, Senior Policy Adviser at RWJF. “Everyone deserves the right to access the supports they need as it becomes more difficult to manage their daily activities on their own.”

“Our hope is for these findings to inform policy opportunities to better support Medicare beneficiaries and their caregivers,” said Johanna Barraza-Cannon, Director at ATI Advisory and Project Director. “For example, policies can target financial support towards the younger female caregivers of Black and Latino/a beneficiaries. Policymakers should also consider how to protect Black beneficiaries from the financial burdens of healthcare they are disproportionately likely to experience.”

This databook is the first of several data analyses, policy briefs, and qualitative research planned as part of a collaborative project to address equity in access to long-term services and supports including paid and unpaid assistance provided at home, in the community, or in a facility setting, such as personal care, adult day centers, day habilitation, prevocational services, transportation, or home modifications. This databook is funded by the Robert Wood Johnson Foundation (RWJF).

About The Robert Wood Johnson Foundation:
The Robert Wood Johnson Foundation is committed to improving health and health equity in the United States. In partnership with others, we are working to develop a Culture of Health rooted in equity that provides every individual with a fair and just opportunity to thrive, no matter who they are, where they live, or how much money they have. For more information, visit

About ATI Advisory:
ATI Advisory is a healthcare research and advisory services firm dedicated to solving the hardest problems in healthcare so that it works better for those who need it most. ATI delivers top expertise, objective research and practical solutions to public and private leaders addressing the most complex needs in healthcare. Its nationally recognized experts apply the highest standards in research and advisory services to generate new ideas, solve hard problems, and reduce uncertainty in a rapidly changing healthcare landscape. For more information, visit


Robert Shalett
Director of Communications
ATI Advisory

Melissa Blair
Robert Wood Johnson Foundation

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