By Phillip Reese,

KFF Health News

A growing number of California's oldest residents are dying of poor nutrition, a yearslong pattern that sped up during the coronavirus pandemic.

Deaths credited to malnutrition more than doubled, from about 650 in 2018 to approximately 1,400 in 2022, according to preliminary death certificate data from the California Department of Public Health. The same trend took place across the country, with malnutrition deaths more than doubling, from about 9,300 deaths in 2018 to approximately 20,500 in 2022, according to the U.S. Centers for Disease Control and Prevention.

Malnutrition is especially typical among older people, particularly those who are ill, low-income, homebound or lack reputable access to healthy food or medical services. It can arise from not consuming enough but likewise from bad eating practices that result in dietary shortages. The majority of deaths in California from poor nutrition last year occurred in citizens 85 and older.

Coronavirus lockdowns, numerous experts stated, likely cut off access to healthy food. Because the oldest individuals were the most likely to pass away from COVID-19, authorities motivated them to restrict their exposure to others who may have the illness.

" People who may have been dependent on public transportation or reliant on others to get to the grocery store-- suddenly they're nervous to take the bus," said Lindsay Clarke, senior vice president of health education and advocacy at the Alliance for Aging Research, a nonprofit in Washington, D.C. "That member of the family or buddy who would have come to pick them up and take them to the supermarket is fretted about having them in their car."

Pandemic lockdowns likewise prevented safeguard programs that feed senior citizens. Numerous adult day care centers closed, for example, removing locations for elders to go during the day as an alternative to nursing care. Dr. Louise Aronson, a geriatrician and teacher at the UC San Francisco, said elders who utilized the programs "might rely on the food they get there as their finest meal of the day."

Malnutrition deaths increased in 2022 even as lockdowns faded. The persistence of the trend, specialists stated, might be because some of the earliest citizens continue separating.

COVID-19 remains a serious threat for that demographic.

About 5,400 Californians 85 and older passed away from COVID-19 in 2015, making it the 5th leading cause of death for that age group-- responsible for more than twice as many deaths as diabetes, preliminary state information programs.

" For a great deal of individuals who are older grownups and individuals with impairments, it's not truly over," stated Trinh Phan, who works from California for the not-for-profit Justice in Aging.

Phan said numerous older Californians are afraid of COVID-19, asking themselves, "Do I actually wish to run the risk of that for myself offered my own risk aspects?"

While the number of California malnutrition deaths leapt throughout the pandemic, it had been increasing for years. Some of that increase might be because of the overall aging of the population, professionals said.

About 678,000 Californians are 85 or older, a number that increased by roughly 59% from 2000 to 2021, census information programs.

Californians 85 or older accounted for practically 3 in 5 poor nutrition deaths in the state in 2015. Those 95 or older make up nearly one in 5 malnutrition deaths, even though only about one in 700 Californians fall within that age group.

" Biologically, we do consume less as we grow older," Aronson stated. "You're simply actually less hungry."

Older people also have slower metabolic process and digestion than younger individuals.

" When you're eating less food in general," Aronson said, "it's tough to get all the nutrients you need."

More factors beyond pandemic lockdowns and an aging population might also be causing the high rise in reported malnutrition amongst older people. The rate of poor nutrition deaths per 100,000 locals in California amongst those 85 or older increased precipitously around 2013, leaping five-fold by 2019 and from there, doubling throughout the pandemic.

Complicating the picture is how typically poor nutrition appears in combination with other diseases. Older adults are more vulnerable to illness-- such as cardiac arrest, cancer, Alzheimer's and depression-- that can minimize their appetites and cause malnutrition as a secondary cause of death.

Poor nutrition was a contributing cause in 5,600 deaths in California on top of the 1,400 deaths for which it was the primary, underlying cause, provisionary CDC information programs. The variety of deaths for which malnutrition was a secondary cause of death rose by about 1,700, or 43%, from 2018 through 2022.

" You may be admitted with diabetes but at the same time, you're likewise malnourished, therefore the malnourishment contributes to your issues," said Paul Brown, a teacher at UC Merced who has copresented papers on poor nutrition in California at an American Public Health Association conference.

There is also an increased push to recognize malnutrition. Two of the country's leading nutrition science companies released updated standards in 2012 to better standardize diagnoses.

The highest malnutrition death rates among older Californians from 2020 to 2022 remained in rural or semirural counties: Lake, Merced, Butte, Tuolumne and Sutter.

Older locals residing in rural counties, Brown said, typically reside in "food deserts," which are locations that do not have access to healthy food.

Among large, city counties, Sacramento had the greatest rate of poor nutrition deaths amongst those 65 or older from 2020 to 2022. County representative Macy Obernuefemann said the general public health agency helps manage and manage persistent diseases frequently accompanied by poor nutrition which a number of programs assist seniors get the food they require.

Several programs in California look for to lower poor nutrition amongst older individuals. The agencies also routinely try to make sure senior citizens are enrolled in CalFresh, the state's food help program for qualified low-income homeowners, Eisenberg stated.

CalFresh benefits increased in late 2021 by 27%, helping lots of elders pay for food. An expense in the legislature, state Senate Bill 600, would increase the minimum CalFresh take advantage of $23 a month to $50. There's likewise a push to expand CalFresh advantages to more undocumented immigrants, a lot of whom face food insecurity.

" I think that there has been truly positive motion," Phan said.

But enhanced CalFresh advantages that provided countless people more money during the pandemic ended in late March.

Population patterns suggest malnutrition will continue to be a problem. The number of Californians 85 and older, the group most susceptible to malnutrition, is projected to grow by about 420,000, or 54%, from 2020 to 2030, according to state Department of Finance projections.

Phillip Reese is an information reporting expert and an assistant professor of journalism at Cal State Sacramento.

This article was produced by KFF Health News, which releases California Healthline, an editorially independent service of the California Health Care Foundation. KFF Health News is a national newsroom that produces thorough journalism about health concerns and is among the core operating programs at KFF - - an independent source of health policy journalism, research study and ballot..