Older adults in economically disadvantaged neighborhoods face dramatically worse outcomes after hip fractures, spending nearly a month less at home during their first year of recovery compared to those in affluent areas, according to a new study published in JAMA Network Open.
Researchers analyzed Medicare data from over 52,000 older adults with hip fractures and found that people in the most disadvantaged neighborhoods spent about 23 fewer days at home after their injury, even after accounting for age and chronic illnesses. Those living in deprived areas were more likely to identify as members of racial or ethnic minority groups and to be dually eligible for Medicare and Medicaid.
Jason R. Falvey, Associate Professor at the University of Maryland School of Medicine, explained that older adults in neighborhoods like West Baltimore face compounded challenges including limited access to rehabilitation services, fewer caregiver supports, and broken sidewalks that impede mobility. These factors make regaining independence after a hip fracture significantly harder.
The study used the Area Deprivation Index, measuring income, education, employment, and housing quality to categorize neighborhoods.
Patients from disadvantaged areas spent more time in skilled nursing facilities and long-term care settings rather than recovering at home.
Falvey emphasized the urgent need for community-tailored recovery programs and policy interventions beyond hospital walls. He advocates for investing in community resources, caregiver supports, and safe neighborhood infrastructure to help more older adults age in place regardless of where they live.
See: “New study finds where you live affects recovery after a hip fracture” (December 23, 2025)
