Racial/Ethnic Group Differences in the Incidence of Self-Neglect: Variation Across Metropolitan and Rural Regions

This study describes how racial/ethnic group differences in self-neglect incidence varied across metropolitan and rural regions of Texas. The data included 134,538 cases of self-neglect validated by adult protective services among people 65+ years old from 2020 to 2023. We aggregated county population figures from US Census Bureau estimates and used negative binomial regression models to estimate the association of race/ethnicity, gender, and region type with self-neglect case counts. Self-neglect incidence among Black older adults was about twice that of White older adults, a difference that persisted across metropolitan regions. Black-White differences were more pronounced in Northwest rural regions but were absent in the El Paso region. Hispanic-White differences varied across both metropolitan and rural regions. In the Arlington region, for example, self-neglect incidence among Hispanic older adults was less than that of White older adults, whereas in San Antonio it was greater. Addressing self-neglect among Black and Hispanic older adults should anticipate that different communities may require distinct approaches. Future studies with more geographic units should build on this descriptive study to explain variation in racial/ethnic group differences in self-neglect incidence.