Abstract
Three major theoretical perspectives have been used to discuss racial disparities in the use of institutionalization, particularly nursing homes, by African-American & white elderly -- the double-jeopardy hypothesis, the age as leveler hypothesis, & the hypothesized African-American subculture. The first two hypotheses are frequently conceptualized as contradictory & tested against each other, yielding mixed & inconclusive results. The cultural hypothesis tends to be offered as an explanation for racial differences in research, rather than explicitly tested. It is concluded that current theory in aging is inadequate to explain the need for, & utilization of, institutional care of African-American elderly. Large-scale theories, eg, those dealing with political economy, are likely to be necessary for explaining some aspects of this issue, eg, need for & access to care. Likewise, cultural theories may help in understanding preferences for some forms of care over others, particularly where such theories are grounded in data.