Due to population aging, cognitive decline is considered a major public health concern. The interplay between cognitive health and care utilization is significant. Cognitive impairment drives the need for healthcare services and influences the trajectory of care utilization over time. The prevalence of mental health disorders among older adults in long-term care facilities is notably high, often exacerbated by factors such as socioeconomic status, access to care, and systemic inequities. Understanding these relationships is essential for developing effective interventions aimed at improving mental health outcomes in this vulnerable population. This chapter highlights how population diversity challenges different psychosocial issues impacting the quality of life of older adults residing in long-term care settings. Implementing systemic changes to ensure equitable health outcomes, particularly for those from minoritized backgrounds, is vital for improving culturally competent care practices and reducing inequities in long-term care facilities.