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.
Keywords: Malnutrition; Texas; assets; death rates; older population.