County-Level Characteristics Driving Malnutrition Death Rates among Older Adults in Texas.

Abstract

ObjectivesThis 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.DesignSecondary 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.SettingAll 254 counties in the state of Texas.ParticipantsIndividuals aged 65 years and older.MeasurementThe 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.ResultsThe 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).ConclusionSocioeconomic disadvantages at the county-level appear to be one of the root causes of malnutrition crude death rates in Texas.