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

This study examines racial/ethnic group differences in self-neglect incidence and describes how these differences varied across eleven regions of Texas. The county-based regions are used by state agencies and include both metropolitan (e.g., Houston) as well as rural (e.g., Abilene) areas. 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 calculated incidence and incident rate ratios (IRRs) stratified by gender, race/ethnicity, and region. Self-neglect incidence among Black older adults was nearly twice that of White older adults, a difference that persisted across metropolitan regions. Yet, Black-White differences were much more pronounced in certain rural regions. Hispanic-White IRRs varied across both metropolitan and rural regions. In one rural region, for example, self-neglect incidence among Hispanic older adults was more than twice that of White older adults; in others it was less than half that of White older adults. 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.<br>