Date of Award

Spring 1-26-2023

Embargo Period

2-15-2023

Document Type

Dissertation

Degree Name

Doctor of Health Administration

Department

Health Administration

College

College of Health Professions

First Advisor

Mary Dooley

Second Advisor

Zahi Jurdi

Third Advisor

Jiebing Wen

Abstract

Objective: The primary objective of this study is to evaluate the impacts of food deserts on hospital admissions for individuals residing in the state of Florida.

Methods: The study design is a retrospective research cohort study analysis of Healthcare Cost Utilization Project (HCUP) data. Inpatient data for the entire state of Florida will be utilized. ICD 10 codes were used to identify malnutrition to evaluate health care utilization by zip code using a geospatial analysis identifying areas known to be food deserts based on United States Department of Agriculture (USDA) designated food census tracts. The data was accessed for the calendar year of 2018, which will offer the most recent complete hospital admissions data for Florida (HCUP, 2022).

Results: This study includes data for 540,278 individuals. Older adults (65 years of age and older) are 73% more likely than younger adults to have an admission to an acute care hospital due to malnutrition while residing in a non-food desert and 29% more likely while residing in a food desert. The 65 years of age and older population while residing in food deserts have 16.8% increase in odds to be admitted to a hospital for malnutrition. There is a statistically significant higher prevalence of obesity in older adults residing in a food desert, and lower length of stay combined with a higher rate of septicemia.

Conclusion: Residing in a Florida zip code designated as 100% food desert correlates with worse health outcomes and greater social risk factors. Addressing food insecurity, screening for malnutrition, and improving the effectiveness of state and national programs for those residing in food deserts could address the over utilization and poor outcomes associated with food deserts and community-based malnutrition.

Rights

Copyright is held by the author. All rights reserved.

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