If you are no longer able to care for yourself in the future, how comfortable would you be living in a nursing home? About 7 in 10 adults say they would be somewhat or very uncomfortable, and more women than men cited personal safety as a major concern, according to a recent poll from Gallup and West Health. Overall, Americans give nursing homes an average D+ grade for quality of care.

Tim Lash, the president of West Health, a nonprofit medical research organization that conducted the survey alongside Gallup, said he was shocked by the findings.

We anticipated concerns around costs, but the concerns around quality and safety were particularly shocking,” Lash said. “At a system level people often say U.S. healthcare could be done better, but people tend to feel pretty good about individual instances with their doctor or hospital. To have so many say they were concerned about quality of care, and women citing safety concerns — that was a little frightening and much higher than we thought it was going to be.”

The survey was conducted over the course of three weeks in July via a nationally representative sample of adults, including those who might not have any personal connection to nursing homes. It was released just after the Biden administration released the first-ever nursing home staffing requirements, the most significant change to regulations since they were first created 50 years ago. Still, the survey found that American adults are most concerned with the quality of care, cost and potential emotional and mental toll of aging in nursing homes. About 1 in 3 women said they would be worried about their physical safety at a nursing home, while men were more likely to say they were worried about losing their independence.

Linda Edelman, a professor at University of Utah’s College of Nursing, said that it makes sense that women are more concerned about safety given that most of the more public cases of egregious physical and sexual violence in nursing homes have been against women.

“Women in general are more concerned about safety, and I think that’s a lifelong concern,” said Edelman, who is also the director of the Hartford Center of Geriatric Nursing Excellence. “That carries on into a setting where they are at their most vulnerable time in their lives and physically frail.”

Concerns around aging in the United States is an inherently gendered issue: Women make up more than two-thirds of the nursing home population, and about 90 percent of nursing home aides are women. The majority of family caregivers in the home are women. And demand for care is likely to grow as the 85-plus demographic, which is also overwhelmingly women, is expected to more than triple by 2050.

Read the full article about nursing home concerns by Mariel Padilla at The19th.