County-Level Characteristics Driving Malnutrition Death Rates among Older Adults in Texas
C D Bergeron1, J M John, M Sribhashyam
1Matthew Lee Smith, Department of Environmental and Occupational Health, School of Public Health, Texas A and M University, College Station, TX, USA, matthew.smith@tamu.edu.
Objectives:
This study aims to identify older adult malnutrition in Texas, examine county-level characteristics associated with crude malnutrition death rates, and describe assets and opportunities available to address and improve malnutrition among the older population.
Design:
Secondary data analysis using the Centers for Disease Control and Prevention's WONDER online database, the U.S. Census 2014-2018 American Community Survey, and the U.S. Department of Agriculture's Food Access Research Atlas data.
Setting:
All 254 counties in the state of Texas.
Participants:
Individuals aged 65 years and older.
Measurement:
The dependent variable was the proportion of county-level malnutrition crude death rates. Independent variables included Health Provider Shortage Area designations, rurality, poverty status, food access, age, race, ethnicity, and education.
Results:
The overall malnutrition crude death rate in Texas was 65.6 deaths per 100,000 older Texans, ranging from 0 to 414.46 deaths per 100,000 depending on the county. Higher malnutrition crude death rates were associated with non-metropolitan counties (P=0.018), lower education (P=0.047), greater household poverty (P=0.010), and low food access (P<0.001).
Conclusion:
Socioeconomic disadvantages at the county-level appear to be one of the root causes of malnutrition crude death rates in Texas.
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