OLDER ADULTS BEHAVIORAL HEALTH PROFILES

REGION 3

DELAWARE 

DISTRICT OF COLUMBIA 

MARYLAND

PENNSYLVANIA

VIRGINIA

WEST VIRGINIA

VA

PA

WV

MD

DC

DE 

A Behavioral Health Resource

SAMHSA’s State Technical Assistance Contract 

August 2016
OLDER ADULTS BEHAVIORAL HEALTH PROFILES

Developed under the Substance Abuse and Mental Health Services Administration’s State Technical Assistance 

Task Order. Reference #HHSS283201200002I/Task Order No. HHSS28342002T.

OVERVIEW

The Substance Abuse and Mental Health Services Administration 

recognizes the importance of behavioral health for older adults and 

the key role states and communities play in addressing the needs of this 

vital and growing population. Administrators need clear and concise 

information to plan, implement, and evaluate effective prevention and 

treatment efforts in their states. 

The Older Adults Behavioral Health Profiles help states and communities 

identify focus areas for behavioral health plans, select population-level 

goals, and coordinate and target services to address priority issues. The 

profiles compare state trends with those in the region and the nation. 

State and community administrators, planners, and providers can use 

the information in these profiles and their own data, knowledge, and 

experience to establish and implement policies that improve the 

health and future of our valued older citizens.

Disclaimer: Data were current at the time this document was prepared.
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

Delaware
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

August 2016

DELAWARE’S POPULATION

Delaware Population by Age Group

Delaware is home to 935,614 people. 

Of these:

• 345,838 (37.0 percent) are over age 50.

• 212,184 (22.7 percent) are over age 60.

• 101,557 (10.9 percent) are over age 70.

• 36,606 (3.9 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 60.9 percent of the 80+ group. 

The racial/ethnic composition of older 

Delawareans is as follows:

Race/Ethnicity of Delawareans 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

79.1% 0.5% 17.1% 2.5% 0.0% 0.8% 3.3%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

NH/PI stands for Native Hawaiian and Other Pacific Islander.

Exhibit 1. Delaware Population by Age Group, 2014

57 59 64

55 57

64

51

30

14

56 58

64

57 61

70

59

35

22

0

20

40

60

80

100

120

140

160

0 to 9 10 to 19 20 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 to 79 80+

Male Female

Population in 1,000s

Source: U.S. Census Bureau, 2015

The Number of Older Delawareans Is Growing

The proportion of Delaware’s 

population that is 65 and older is 

growing while the proportion that is 

younger than 65 is shrinking. The 

U.S. Census Bureau estimates that 

23.5 percent of Delaware’s population 

will be 65 and older by the year 2030, 

an increase of 60.0 percent from 2015.

Projected Population in Delaware

Age Group 2015 2025 2030

Under 18 22.6% 22.0% 21.6%

18 to 44 32.9% 30.8% 30.0%

45 to 64 28.5% 26.2% 24.9%

65+ 16.0% 21.1% 23.5%

Source: U.S. Census Bureau, 2005

Exhibit 2. Delaware Population by Age Group, 2000–2030

0

50

100

150

200

250

300

350

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

Delaware Population in 1,000s
2

Delaware Delaware Profile 2016

SUICIDE AMONG OLDER ADULTS IN REGION 3

Region 3 Suicide Rates Compared With National Rates

Suicide data for Delawareans of 

various ages were unavailable for 

2013. Therefore, the rates for Region 3 

(including the District of Columbia, 

Maryland, Pennsylvania, Virginia, and 

West Virginia) are used instead. 

The suicide rate among individuals ages 

50+ in Region 3 was higher than the rate 

among younger age groups. In 2013, the 

total suicide rate among all people ages 

50+ was 17.1 per 100,000 people (6.2 

for women and 29.9 for men). The rate 

among those ages 50–64 was lower than 

the rate in the United States. 

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in Region 3 and the United 

States, 2013

12.9

10.5

18.5

15.2

13.0

10.6

19.0

16.1

0

2

4

6

8

10

12

14

16

18

20

All Under 50 50 to 64 65+

Region 3 U.S.

Source: Centers for Disease Control and Prevention (CDC), National Center 

for Health Statistics (NCHS), Underlying Cause of Death 1999-2013 on CDC 

WONDER Online Database, released 2015

Trends in Suicide Rates in Region 3

Suicide data for Delawareans of 

various ages were unavailable. 

Therefore, the rates for Region 3 are 

used instead.

The suicide rate among individuals in 

Region 3 ages 50+ fluctuated from a 

low of 13.9 per 100,000 in 2004 and 

2006 to a high of 17.1 per 100,000 

in 2013. From 2004 to 2013, the rate 

was generally highest among those in 

the 50–64 age group. 

How a state reports suicides can vary 

from year to year. The number of 

suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

Exhibit 4. Trends in Suicide Rates in Region 3 by Age Group, 

2004–2013

0

2

4

6

8

10

12

14

16

18

20

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Suicide Rate per 100,000 Population

Suicide Rate per 100,000 Population

Source: CDC, NCHS, Underlying Cause of Death 1999-2013 on CDC WONDER 

Online Database, released 2015
Alabama ALABAMA Profile 2015 Delaware Delaware Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER DELAWAREANS

30-Day Binge Drinking Among Older Delawareans

Binge drinking, defined as five or more 

drinks for men and four or more drinks 

for women on a single occasion, can 

lead to serious health problems. Such 

problems include neurological damage, 

cardiovascular disease, liver disease, 

stroke, and poor control of diabetes. 

Binge drinkers are more likely to take risks 

such as driving while intoxicated and to 

experience falls and other accidents. Older 

people have a lower tolerance for alcohol. 

Binge drinking decreases with age and 

occurs more frequently among men than 

it does among women. As Exhibit 5 shows, 

13.6 percent of Delaware men ages 50–64 

reported binge drinking in the past 

30 days, while 8.0 percent of those in the 

65+ group reported similar behavior. 

Exhibit 5. Binge Drinking Rates in Delaware by Age 

Group and Sex, 2013

31.8%

13.6% 

8.0%

17.4%

9.5%

3.2%

0%

5%

10%

15%

20%

25%

30%

35%

18 to 49 50 to 64 65+

Male Female

Source: Behavioral Risk Factor Surveillance System (BRFSS), 2013

Illicit Drug Use Among Older Americans

Nationally, the rate of illicit drug use 

among older adults ages 50–64 more 

than doubled from 2002 to 2013. 

This development partially reflects 

the entrance into this age group of 

the baby boom cohort, whose rates 

of illicit drug use have been higher 

than those of older cohorts. Although 

state-specific data are not available, the

Delaware Behavioral Health Barometer

is available for download from the 

Substance Abuse and Mental Health 

Services Administration (SAMHSA) 

website (www.samhsa.gov/data 

/population-data-nsduh 

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

50 to 54 55 to 59 60 to 64

Source: National Survey on Drug Use and Health (NSDUH), 2013

Illicit drug use includes illegal drugs and prescription drugs used nonmedically. SAMHSA 

provides a list of drugs included in its survey in the NSDUH methodological summary.

Proportion Using in Past Month

Proportion of Population Engaging in Binge Drinking
4

Delaware Delaware Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Delawareans

In 2012, there were 709 admissions 

of Delawareans ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 205.0 per 100,000 

people ages 50+. This rate was lower 

than the regional rate and the national 

average. Men made up 72.5 percent of 

these admissions. Of all admissions, 

62.0 percent were White/Caucasian, 

36.0 percent were Black/African 

American, and 2.7 percent were 

Hispanic. 

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

69.6% 19.0% 11.4%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Delaware, Region 3, and the United States by Sex, 2012

322.9

462.0

383.2

104.6

154.4

120.3

0

50

100

150

200

250

300

350

400

450

500

Delaware Region 3 U.S.

Male Female

Source: Treatment Episode Data Set (TEDS), 20121

1

 TEDS data are collected by states as a condition of the Substance Abuse Prevention and Treatment Block Grant. Guidelines suggest that states report all clients 

admitted to publicly financed treatment; however, states are inconsistent in applying the guidelines. States may structure and implement different quality controls 

over the data. For example, states may collect different categories of information to answer TEDS questions. Information is then “walked over” to TEDS definitions.

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions Among Delawareans Ages 50+ by Insurance Type 

In Delaware, 74.8 percent of older 

adult admissions to SUD treatment 

were uninsured, 15.6 percent had 

Medicaid, 7.3 percent had Medicare, 

and 2.2 percent had private insurance.

SUD Treatment Admissions Among 

Delawareans Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

1.5% 8.2% 90.3%

Self-pay data include private insurance.

Exhibit 8 and the accompanying text reflect the type of 

health insurance (if any) clients had at admission; the table 

above represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 

50+ in Delaware, Region 3, and the United States by 

Insurance Type, 2012

2.2%

15.6%

7.3%

74.8%

16.7%

32.4%

17.0%

33.9%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

Delaware Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of SUD Treatment Admissions of Adults Ages 50+ by Insurance Type

SUD Admission Rate per 100,000 Population
Alabama ALABAMA Profile 2015 Delaware Delaware Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Delawareans Ages 50+

Alcohol was the most frequently cited 

substance used by older Delawareans 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 46.8 percent of admissions 

among those ages 50+. This was lower 

than the regional and national rates.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Delaware, Region 3, and the United States, 

2012

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

46.8%

50.4%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Delaware Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions for Non-Alcohol Substance Use

Substances other than alcohol were 

cited as the primary substances of 

use for 53.2 percent of older adult 

admissions to publicly funded 

treatment in Delaware.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Delaware, Region 3, 

and the United States, 2012

er

53.2%

49.6%

37.9%

0%

10%

20%

30%

40%

50%

60%

Delaware Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With Other Primary Substance Use Disord
6

Delaware Delaware Profile 2016

Drug-Related Emergency Department Visits Involving Pharmaceutical Misuse 

and Abuse by Older Adults

SAMHSA periodically releases reports from the Drug Abuse Warning Network (DAWN). DAWN, discontinued 

in 2011, consisted of a nationwide network of hospital emergency departments (EDs) primarily located in 

large metropolitan areas. DAWN data consist of professional reviews of ED records to determine the extent 

to which alcohol and other substance abuse was involved in ED visits. According to the November 25, 2010, 

DAWN Report:

• In 2004, there were an estimated 115,803 ED visits involving pharmaceutical misuse and abuse by adults 

aged 50 or older; in 2008, there were 256,097 such visits, representing an increase of 121.1 percent 

• One fifth (19.7 percent) of ED visits involving pharmaceutical misuse and abuse among older adults were 

made by persons aged 70 or older 

• Among ED visits made by older adults, pain relievers were the type of pharmaceutical most commonly 

involved (43.5 percent), followed by drugs used to treat anxiety or insomnia (31.8 percent) and 

antidepressants (8.6 percent) 

• Among patients aged 50 or older who visited the ED for pharmaceutical misuse or abuse, more than half 

(52.3 percent) were treated and released, and more than one third (37.5 percent) were admitted to the 

hospital 

Bulleted text in italics above is taken from SAMHSA’s Center for Behavioral Health Statistics and Quality. (2010, November 25). The DAWN Report: Drugrelated emergency department visits involving pharmaceutical misuse and abuse by older adults. Rockville, MD: SAMHSA.

CO-OCCURRING SUBSTANCE USE AND MENTAL DISORDERS

Older Delawareans in SUD Treatment With Co-Occurring Mental Disorders

The national literature shows a strong 

relationship between substance use 

and mental disorders. Studies show 

that 30–80 percent of individuals with a 

substance use or mental disorder also 

have a co-occurring disorder. 

Exhibit 11 shows the proportion 

of SUD treatment admissions of 

Delawareans ages 50+ with a cooccurring mental disorder. This rate 

is lower than the regional rate and 

the national average. However, state 

reporting practices are a factor in 

these results.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Delaware, Region 3, 

and the United States, 2012

1.6%

43.6%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Delaware Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders
Alabama ALABAMA Profile 2015 Delaware Delaware Profile 2016

7

MENTAL HEALTH

Older Delawareans Reporting Frequent Mental Distress

BRFSS, a household survey conducted in 

all 50 states and several territories, asks 

the following question: “Now thinking 

about your mental health, which includes 

stress, depression, and problems with 

emotions, for how many days during the 

past 30 days was your mental health not 

good?” Those individuals reporting 14 

or more “Yes” days in response to this 

question experience frequent mental 

distress (FMD). Exhibit 12 shows that 

older Delawareans experience FMD at a 

rate that is higher than the regional rate 

and roughly similar to the national rate. 

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Delaware, Region 3, and the United States, 2013

11.8%

12.7%

7.3%

12.7%

12.3%

7.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

Delaware Region 3 U.S.

Source: BRFSS, 2013

Older Delawareans Reporting Frequent Mental Distress by Age Group and Sex

Older men in Delaware were more likely 

to indulge in binge drinking, but older 

women were more likely to report that 

they had FMD (14 days or more per 

30-day period). As Exhibit 13 shows, 

15.7 percent of women in the 50–64 age 

group and 7.5 percent in the 65+ age 

group reported FMD, while 9.6 percent 

of men in the 50–64 age group and 

7.1 percent in the 65+ age group 

reported FMD.

Exhibit 13. Delawareans Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

8.7%

14.8%

9.6%

15.7%

7.1% 7.5%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

Male Female

18 to 49 50 to 64 65+

Proportion Reporting Frequent Mental Distress

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Delaware Delaware Profile 2016

Other Measures of Mental Health

BRFSS collected other measures showing risk factors for mental and/or physical illness. These included:

• Social and Emotional Support (2010). BRFSS asked, “How often do you get the social and emotional 

support you need?” The possible responses were always, usually, sometimes, rarely, or never. 

• Life Satisfaction (2010). BRFSS asked, “In general, how satisfied are you with your life?” The possible 

responses were very satisfied, satisfied, dissatisfied, or very dissatisfied.

Exhibit 14 presents the results of these surveys among older Delawareans.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 6.5% 5.0% 8.5%

Dissatisfied or very 

dissatisfied 4.9% 5.8% 3.8%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical 

health.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Source: BRFSS, 2013

Proportion Reporting Poor Physical Health
Alabama ALABAMA Profile 2015 Delaware Delaware Profile 2016

9

Relationship Among Mental Distress, Diabetes, Stroke, Heart Attack, 

High Blood Pressure, and Coronary Disease

Older Americans who experience FMD 

are more likely to report that they have 

health problems. People with FMD 

were more than twice as likely to report 

having a stroke than those with some 

or no mental distress. They experienced 

coronary disease and heart attack at 

more than 1.6 times, diabetes at more 

than 1.4 times, and high blood pressure 

at nearly 1.2 times the rate of those with 

some or no mental distress.

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

10.1%

13.3% 13.2%

25.9%

60.6%

4.7%

7.6% 7.8%

17.7%

51.1%

0%

10%

20%

30%

40%

50%

60%

70%

Stroke Coronary disease Heart attack Diabetes High blood pressure

Frequent mental distress Some or no mental distress

Source: BRFSS, 2013

Older Delawareans Admitted to State Mental Health Services

Approximately 5.5 percent of the people served by the Delaware mental health system were ages 65 and 

older. This represents more than 540 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014 Proportion Reporting Health Problems by Mental Health Category
10 Delaware Delaware Profile 2016

DATA SOURCES

BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (www.cdc.gov/brfss). BRFSS, managed by CDC, 

is the largest ongoing telephone health survey system in the world, tracking health conditions and risk 

behaviors in the United States annually since 1984. Data are collected on a monthly basis in all 50 states, 

the District of Columbia, and participating territories. BRFSS data are collected by local jurisdictions and 

reported to CDC.

CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL CENTER FOR HEALTH 

STATISTICS, UNDERLYING CAUSE OF DEATH 1999-2013 ON CDC WONDER ONLINE DATABASE, 

RELEASED 2015 (http://wonder.cdc.gov/ucd-icd10.html). The WONDER online database “contains 

mortality and population counts for all U.S. counties. Data are based on death certificates for U.S. 

residents. Each death certificate identifies a single underlying cause of death and demographic data. 

The number of deaths, crude death rates or age-adjusted death rates, and 95% confidence intervals 

and standard errors for death rates can be obtained by place of residence (total U.S., region, state and 

county), age group (single-year-of age, 5-year age groups, 10-year age groups and infant age groups), 

race, Hispanic ethnicity, gender, year, cause-of-death (4-digit ICD-10 code or group of codes), injury 

intent and injury mechanism, drug/alcohol induced causes and urbanization categories. Data are also 

available for place of death, month and week day of death, and whether an autopsy was performed.”

CENTER FOR MENTAL HEALTH SERVICES UNIFORM REPORTING SYSTEM (www.samhsa.gov/data

/us_map). States that receive CMHS Block Grants are required to report aggregate data to URS. URS 

reports include information about utilization of mental health services and client demographic and 

outcome information.

NATIONAL SURVEY ON DRUG USE AND HEALTH (https://nsduhweb.rti.org). The NSDUH, managed 

by SAMHSA, is “an annual nationwide survey involving interviews with approximately 70,000 randomly 

selected individuals aged 12 and older.” NSDUH data are most frequently used by state planners 

to assess the need for SUD treatment. NSDUH data also include information about mental health 

conditions.

TREATMENT EPISODE DATA SET (www.samhsa.gov/data/client-level-data-teds/reports?tab=19). States 

that receive Substance Abuse Prevention and Treatment Block Grant funds submit individual client data 

to TEDS. TEDS includes both admission and discharge data sets, and some 1.5 million admissions are 

reported annually. TEDS includes information about utilization of SUD treatment services and client 

demographic and outcome information. TEDS is an admission-based system, and TEDS admissions do 

not represent individuals. Thus, an individual admitted to treatment twice within a calendar year would 

be counted as two admissions.

U.S. CENSUS BUREAU (www.census.gov/people). Two main sources of Census Bureau data were used 

in this report: (1) population estimates and (2) population projections.
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

District of Columbia
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

August 2016

DISTRICT OF COLUMBIA’S POPULATION

District of Columbia Population by Age Group

The District of Columbia is home to 658,893 

people. Of these:

• 182,731 (27.7 percent) are over age 50.

• 107,117 (16.3 percent) are over age 60.

• 49,522 (7.5 percent) are over age 70.

• 20,190 (3.1 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 66.2 percent of the 80+ group. 

The racial/ethnic composition of older 

Washingtonians is as follows:

Race/Ethnicity of Washingtonians Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

35.2% 0.5% 60.4% 2.4% 0.1% 1.4% 6.4%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native.

NH/PI stands for Native Hawaiian and Other Pacific Islander.

Exhibit 1. District of Columbia Population by Age 

Group, 2014

38

31

63 60

40 37

26

12 7 

36

33

74

63

40 39

32

17

13

0

20

40

60

80

100

120

140

160

0 to 9 10 to 19 20 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 to 79 80+

Male Female

Source: U.S. Census Bureau, 2015

The Proportion of Older Washingtonians Is Growing

The proportion of the District of 

Columbia’s population that is 65 and older 

is growing while the proportion that is 

younger than 65 is shrinking. The U.S. 

Census Bureau estimates that 13.4 percent 

of the District of Columbia’s population 

will be 65 and older by the year 2030. 

However, the total number of individuals 

65 and older is expected to decrease by 

5.6 percent by 2030.

Projected Population in the District of 

Columbia

Age Group 2015 2025 2030

Under 18 22.1% 23.4% 23.2%

18 to 44 44.4% 42.5% 43.5%

45 to 64 21.3% 20.8% 19.9%

65+ 12.2% 13.2% 13.4%

Source: U.S. Census Bureau, 2005

Exhibit 2. The District of Columbia Population by Age 

Group, 2000–2030

0

50

100

150

200

250

300

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

District of Columbia Population in 1,000s Population in 1,000s
2

District of Columbia District of Columbia Profile 2016

SUICIDE AMONG OLDER ADULTS IN REGION 3

Region 3 Suicide Rates Compared With National Rates

Suicide data for Washingtonians of various 

age groups were unavailable. Therefore, 

the rates for Region 3 (including Delaware, 

Maryland, Pennsylvania, Virginia, and West 

Virginia) are used instead. 

The suicide rate among individuals ages 

50+ in Region 3 was higher than the rate 

among younger age groups. In 2013, the 

total suicide rate among all people ages 

50+ was 17.1 per 100,000 people (6.2 for 

women and 29.9 for men). The rate among 

those ages 50–64 was lower than the rate 

in the United States. 

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in Region 3 and the United 

States, 2013

12.9

10.5

18.5

15.2

13.0

10.6

19.0

16.1

0

2

4

6

8

10

12

14

16

18

20

All Under 50 50 to 64 65+

Region 3 U.S.

Source: Centers for Disease Control and Prevention (CDC), National Center 

for Health Statistics (NCHS), Underlying Cause of Death 1999-2013 on CDC 

WONDER Online Database, released 2015

Trends in Suicide Rates in Region 3

Suicide data for Washingtonians 

of various ages were unavailable. 

Therefore, the rates for Region 3 are 

used instead.

The suicide rate among individuals in 

Region 3 ages 50+ fluctuated from a 

low of 13.9 per 100,000 in 2004 and 

2006 to a high of 17.1 per 100,000 

in 2013. From 2004 to 2013, the rate 

was generally highest among those in 

the 50–64 age group. 

How a state reports suicides can vary 

from year to year. The number of 

suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

Exhibit 4. Trends in Suicide Rates in Region 3 by Age Group, 

2004–2013

0

2

4

6

8

10

12

14

16

18

20

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Suicide Rate per 100,000 Population

Suicide Rate per 100,000 Population

Source: CDC, NCHS, Underlying Cause of Death 1999-2013 on CDC WONDER 

Online Database, released 2015
Alabama ALABAMA Profile 2015 District of Columbia District of Columbia Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER WASHINGTONIANS

30-Day Binge Drinking Among Older Washingtonians

Binge drinking, defined as five or more 

drinks for men and four or more drinks 

for women on a single occasion, can 

lead to serious health problems. Such 

problems include neurological damage, 

cardiovascular disease, liver disease, 

stroke, and poor control of diabetes. 

Binge drinkers are more likely to take risks 

such as driving while intoxicated and to 

experience falls and other accidents. Older 

people have a lower tolerance for alcohol. 

Binge drinking decreases with age and 

occurs more frequently among men than 

it does among women. As Exhibit 5 shows, 

16.3 percent of the District of Columbia 

men ages 50–64 reported binge drinking 

in the past 30 days, while 6.4 percent of 

those in the 65+ group reported similar 

behavior. 

Exhibit 5. Binge Drinking Rates in the District of 

Columbia by Age Group and Sex, 2013

36.5%

16.3% 

6.4%

23.7%

8.9%

4.2%

0%

5%

10%

15%

20%

25%

30%

35%

40%

18 to 49 50 to 64 65+

Male Female

Source: Behavioral Risk Factor Surveillance System (BRFSS), 2013

Illicit Drug Use Among Older Americans

Nationally, the rate of illicit drug use 

among older adults ages 50–64 more 

than doubled from 2002 to 2013. 

This development partially reflects 

the entrance into this age group of 

the baby boom cohort, whose rates 

of illicit drug use have been higher 

than those of older cohorts. Although 

state-specific data are not available, the 

District of Columbia Behavioral Health 

Barometer is available for download 

from the Substance Abuse and 

Mental Health Services Administration 

(SAMHSA) website (www.samhsa.gov

/data/population-data-nsduh

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

50 to 54 55 to 59 60 to 64

Source: National Survey on Drug Use and Health (NSDUH), 2013

Illicit drug use includes illegal drugs and prescription drugs used nonmedically. SAMHSA 

provides a list of drugs included in its survey in the NSDUH methodological summary.

Proportion Using in Past Month

Proportion of Population Engaging in Binge Drinking
4

District of Columbia District of Columbia Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Washingtonians

In 2012, there were 1,953 admissions of 

Washingtonians ages 50 and older to 

substance use disorder (SUD) treatment 

in state-funded treatment programs, 

a rate of 1,068.8 per 100,000 people 

ages 50+. This rate was higher than the 

regional rate and the national average. 

Men made up 76.9 percent of these 

admissions. Of all admissions, 

2.2 percent were White/Caucasian, 

95.6 percent were Black/African 

American, and 3.5 percent were 

Hispanic. 

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

24.2% 10.7% 65.0%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in the District of Columbia, Region 3, and the United 

States by Sex, 2012

1,829.9

462.0

383.2 448.8

154.4 120.3 0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

District of Columbia Region 3 U.S.

Male Female

Source: Treatment Episode Data Set (TEDS), 20121

1

 TEDS data are collected by states as a condition of the Substance Abuse Prevention and Treatment Block Grant. Guidelines suggest that states report all clients 

admitted to publicly financed treatment; however, states are inconsistent in applying the guidelines. States may structure and implement different quality controls 

over the data. For example, states may collect different categories of information to answer TEDS questions. Information is then “walked over” to TEDS definitions.

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions Among Washingtonians Ages 50+ by Insurance Type 

In the District of Columbia, 11.2 percent 

of older adult admissions to SUD 

treatment were uninsured, 67.0 percent 

had Medicaid, 19.0 percent had 

Medicare, and 2.8 percent had private 

insurance.

SUD Treatment Admissions Among 

Washingtonians Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

2.0% 20.1% 77.9%

Self-pay data include private insurance.

Exhibit 8 and the accompanying text reflect the type of 

health insurance (if any) clients had at admission; the table 

above represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in the District of Columbia, Region 3, and the United 

States by Insurance Type, 2012

2.8%

67.0%

19.0%

11.2%

16.7%

32.4%

17.0%

33.9%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

District of Columbia Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of SUD Treatment Admissions of Adults Ages 50+ by Insurance Type

SUD Admission Rate per 100,000 Population
Alabama ALABAMA Profile 2015 District of Columbia District of Columbia Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Washingtonians Ages 50+

Alcohol was the most frequently 

cited substance used by older 

Washingtonians in publicly financed 

SUD treatment in 2012. It was 

mentioned as a substance of use in 

40.7 percent of admissions among 

those ages 50+. This was lower than 

the regional and national rates.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in the District of Columbia, Region 3, and the 

United States, 2012

40.7%

50.4%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

District of Columbia Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions for Non-Alcohol Substance Use

Substances other than alcohol were 

cited as the primary substances of 

use for 59.3 percent of older adult 

admissions to publicly funded 

treatment in the District of Columbia.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in the District of 

Columbia, Region 3, and the United States, 2012

59.3%

49.6%

37.9%

0%

10%

20%

30%

40%

50%

60%

70%

District of Columbia Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

Proportion of Treatment Admissions 50+ With Other Primary Substance Use Disorder
6

District of Columbia District of Columbia Profile 2016

Drug-Related Emergency Department Visits Involving Pharmaceutical Misuse 

and Abuse by Older Adults

SAMHSA periodically releases reports from the Drug Abuse Warning Network (DAWN). DAWN, discontinued 

in 2011, consisted of a nationwide network of hospital emergency departments (EDs) primarily located in 

large metropolitan areas. DAWN data consist of professional reviews of ED records to determine the extent 

to which alcohol and other substance abuse was involved in ED visits. According to the November 25, 2010, 

DAWN Report:

• In 2004, there were an estimated 115,803 ED visits involving pharmaceutical misuse and abuse by adults 

aged 50 or older; in 2008, there were 256,097 such visits, representing an increase of 121.1 percent 

• One fifth (19.7 percent) of ED visits involving pharmaceutical misuse and abuse among older adults were 

made by persons aged 70 or older 

• Among ED visits made by older adults, pain relievers were the type of pharmaceutical most commonly 

involved (43.5 percent), followed by drugs used to treat anxiety or insomnia (31.8 percent) and 

antidepressants (8.6 percent) 

• Among patients aged 50 or older who visited the ED for pharmaceutical misuse or abuse, more than half 

(52.3 percent) were treated and released, and more than one third (37.5 percent) were admitted to the 

hospital 

Bulleted text in italics above is taken from SAMHSA’s Center for Behavioral Health Statistics and Quality. (2010, November 25). The DAWN Report: Drugrelated emergency department visits involving pharmaceutical misuse and abuse by older adults. Rockville, MD: SAMHSA.

CO-OCCURRING SUBSTANCE USE AND MENTAL DISORDERS

Older Washingtonians in SUD Treatment With Co-Occurring Mental Disorders

The national literature shows a strong 

relationship between substance use 

and mental disorders. Studies show 

that 30–80 percent of individuals with a 

substance use or mental disorder also 

have a co-occurring disorder. 

Exhibit 11 shows the proportion 

of SUD treatment admissions of 

Washingtonians ages 50+ with a cooccurring mental disorder. This rate 

is higher than the regional rate and 

the national average. However, state 

reporting practices are a factor in 

these results.

Exhibit 11. SUD Treatment Admissions of Adults Ages 

50+ With a Co-Occurring Mental Disorder in the District of 

Columbia, Region 3, and the United States, 2012

51.1%

43.6%

33.7%

0%

10%

20%

30%

40%

50%

60%

District of Columbia Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders
Alabama ALABAMA Profile 2015 District of Columbia District of Columbia Profile 2016

7

MENTAL HEALTH

Older Washingtonians Reporting Frequent Mental Distress

BRFSS, a household survey conducted in 

all 50 states and several territories, asks 

the following question: “Now thinking 

about your mental health, which includes 

stress, depression, and problems with 

emotions, for how many days during the 

past 30 days was your mental health not 

good?” Those individuals reporting 14 

or more “Yes” days in response to this 

question experience frequent mental 

distress (FMD). Exhibit 12 shows that 

older Washingtonians experience FMD 

at a rate that is higher than the regional 

rate and roughly similar to the national 

rate. 

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in the District of Columbia, Region 3, and the United 

States, 2013

10.1%

13.3%

7.3%

12.7%

12.3%

7.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

District of Columbia Region 3 U.S.

Source: BRFSS, 2013

Older Washingtonians Reporting Frequent Mental Distress by Age Group 

and Sex

As Exhibit 13 shows, in the District 

of Columbia, 12.4 percent of men in 

the 50–64 age group reported FMD 

(14 days or more per 30-day period) 

compared with 14.2 percent of women 

in this age group. Men in the 65+ age 

group reported a higher rate of FMD 

than women in the same age group 

(9.1 percent compared with 6.1 percent). 

Virginia is the only state in the region 

where men in the 65+ age group 

reported a higher rate of FMD than did 

women in this age group. 

Exhibit 13. Washingtonians Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

9.6%

10.6%

12.4%

14.2%

9.1%

6.1%

0%

2%

4%

6%

8%

10%

12%

14%

16%

Male Female

18 to 49 50 to 64 65+

Source: BRFSS, 2013

Proportion Reporting Frequent Mental Distress

Proportion Reporting Frequent Mental Distress
8

District of Columbia District of Columbia Profile 2016

Other Measures of Mental Health

BRFSS collected other measures showing risk factors for mental and/or physical illness. These included:

• Social and Emotional Support (2010). BRFSS asked, “How often do you get the social and emotional 

support you need?” The possible responses were always, usually, sometimes, rarely, or never. 

• Life Satisfaction (2010). BRFSS asked, “In general, how satisfied are you with your life?” The possible 

responses were very satisfied, satisfied, dissatisfied, or very dissatisfied.

Exhibit 14 presents the results of these surveys among older Washingtonians.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 10.8% 8.4% 15.2%

Dissatisfied or very 

dissatisfied 5.3% 6.5% 3.1%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical 

health.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Source: BRFSS, 2013

Proportion Reporting Poor Physical Health
Alabama ALABAMA Profile 2015 District of Columbia District of Columbia Profile 2016

9

Relationship Among Mental Distress, Diabetes, Stroke, Heart Attack, 

High Blood Pressure, and Coronary Disease

Older Americans who experience FMD 

are more likely to report that they have 

health problems. People with FMD 

were more than twice as likely to report 

having a stroke than those with some 

or no mental distress. They experienced 

coronary disease and heart attack at 

more than 1.6 times, diabetes at more 

than 1.4 times, and high blood pressure 

at nearly 1.2 times the rate of those with 

some or no mental distress.

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

10.1%

13.3% 13.2%

25.9%

60.6%

4.7%

7.6% 7.8%

17.7%

51.1%

0%

10%

20%

30%

40%

50%

60%

70%

Stroke Coronary disease Heart attack Diabetes High blood pressure

Frequent mental distress Some or no mental distress

Source: BRFSS, 2013

Older Washingtonians Admitted to State Mental Health Services

Approximately 3.8 percent of the people served by the the District of Columbia mental health system were 

ages 65 and older. This represents more than 900 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014 Proportion Reporting Health Problems by Mental Health Category
10 District of Columbia District of Columbia Profile 2016

DATA SOURCES

BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (www.cdc.gov/brfss). BRFSS, managed by CDC, 

is the largest ongoing telephone health survey system in the world, tracking health conditions and risk 

behaviors in the United States annually since 1984. Data are collected on a monthly basis in all 50 states, 

the District of Columbia, and participating territories. BRFSS data are collected by local jurisdictions and 

reported to CDC.

CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL CENTER FOR HEALTH 

STATISTICS, UNDERLYING CAUSE OF DEATH 1999-2013 ON CDC WONDER ONLINE DATABASE, 

RELEASED 2015 (http://wonder.cdc.gov/ucd-icd10.html). The WONDER online database “contains 

mortality and population counts for all U.S. counties. Data are based on death certificates for U.S. 

residents. Each death certificate identifies a single underlying cause of death and demographic data. 

The number of deaths, crude death rates or age-adjusted death rates, and 95% confidence intervals 

and standard errors for death rates can be obtained by place of residence (total U.S., region, state and 

county), age group (single-year-of age, 5-year age groups, 10-year age groups and infant age groups), 

race, Hispanic ethnicity, gender, year, cause-of-death (4-digit ICD-10 code or group of codes), injury 

intent and injury mechanism, drug/alcohol induced causes and urbanization categories. Data are also 

available for place of death, month and week day of death, and whether an autopsy was performed.”

CENTER FOR MENTAL HEALTH SERVICES UNIFORM REPORTING SYSTEM (www.samhsa.gov/data

/us_map). States that receive CMHS Block Grants are required to report aggregate data to URS. URS 

reports include information about utilization of mental health services and client demographic and 

outcome information.

NATIONAL SURVEY ON DRUG USE AND HEALTH (https://nsduhweb.rti.org). The NSDUH, managed 

by SAMHSA, is “an annual nationwide survey involving interviews with approximately 70,000 randomly 

selected individuals aged 12 and older.” NSDUH data are most frequently used by state planners 

to assess the need for SUD treatment. NSDUH data also include information about mental health 

conditions.

TREATMENT EPISODE DATA SET (www.samhsa.gov/data/client-level-data-teds/reports?tab=19). States 

that receive Substance Abuse Prevention and Treatment Block Grant funds submit individual client data 

to TEDS. TEDS includes both admission and discharge data sets, and some 1.5 million admissions are 

reported annually. TEDS includes information about utilization of SUD treatment services and client 

demographic and outcome information. TEDS is an admission-based system, and TEDS admissions do 

not represent individuals. Thus, an individual admitted to treatment twice within a calendar year would 

be counted as two admissions.

U.S. CENSUS BUREAU (www.census.gov/people). Two main sources of Census Bureau data were used 

in this report: (1) population estimates and (2) population projections.
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

Maryland
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

August 2016

MARYLAND’S POPULATION

Maryland Population by Age Group

Maryland is home to 5,976,407 people. 

Of these:

• 2,043,018 (34.2 percent) are over age 50.

• 1,168,949 (19.6 percent) are over age 60.

• 541,496 (9.1 percent) are over age 70.

• 209,762 (3.5 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 63.6 percent of the 80+ group. 

The racial/ethnic composition of older 

Marylanders is as follows:

Race/Ethnicity of Marylanders 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

66.9% 0.4% 26.4% 5.3% 0.1% 1.0% 4.2%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

NH/PI stands for Native Hawaiian and Other Pacific Islander.

Exhibit 1. Maryland Population by Age Group, 2014

380 390 416 384 393 418

292

147

76

365 374

408

401 423

456

336

184

133

0

100

200

300

400

500

600

700

800

900

1,000

0 to 9 10 to 19 20 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 to 79 80+

Male Female

Source: U.S. Census Bureau, 2015

The Number of Older Marylanders Is Growing

The proportion of Maryland’s population 

that is 65 and older is growing while 

the proportion that is younger than 65 

is shrinking. The U.S. Census Bureau 

estimates that 17.6 percent of Maryland’s 

population will be 65 and older by the 

year 2030, an increase of 47.6 percent 

from 2015.

Projected Population in Maryland

Age Group 2015 2025 2030

Under 18 23.9% 24.6% 24.5%

18 to 44 36.8% 36.8% 36.3%

45 to 64 25.8% 22.2% 21.6%

65+ 13.5% 16.3% 17.6%

Source: U.S. Census Bureau, 2005

Maryland

Exhibit 2. Maryland Population by Age Group, 

2000–2030

Population in 1,000s

Population in 1,000s

0

500

1,000

1,500

2,000

2,500

3,000

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+
2

Maryland Maryland Profile 2016

SUICIDE AMONG OLDER MARYLANDERS

Maryland Suicide Rate Compared With Regional and National Rates

The suicide rate among Marylanders 

ages 50 and older is higher than the rate 

among younger age groups. In 2013, the 

total suicide rate among all people ages 

50+ was 12.8 per 100,000 people (4.8 

for women and 22.3 for men). The rate 

among those ages 50–64 was lower than 

both the rate in the region (including 

Delaware, the District of Columbia, 

Pennsylvania, Virginia, and West Virginia) 

and the rate in the United States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in Maryland, Region 3, and the 

United States, 2013

9.6

8.0

14.5

10.2

12.9

10.5

18.5

15.2

13.0

10.6

19.0

16.1

0

2

4

6

8

10

12

14

16

18

20

All Under 50 50 to 64 65+

Maryland Region 3 U.S.

Source: Centers for Disease Control and Prevention (CDC), National Center 

for Health Statistics (NCHS), Underlying Cause of Death 1999-2013 on CDC 

WONDER Online Database, released 2015

Trends in Suicide Rates in Maryland

The suicide rate among Marylanders 

ages 50+ fluctuated from a low of 

10.8 per 100,000 in 2005 to a high 

of 14.3 per 100,000 in 2012. From 

2004 to 2013, the rate was generally 

highest among those in the 50–64 

age group. 

How a state reports suicides can vary 

from year to year. The number of 

suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

Exhibit 4. Trends in Suicide Rates in Maryland by Age Group, 

2004–2013

Suicide Rate per 100,000 Population

Suicide Rate per 100,000 Population

0

2

4

6

8

10

12

14

16

18

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Source: CDC, NCHS, Underlying Cause of Death 1999-2013 on CDC WONDER 

Online Database, released 2015
Alabama ALABAMA Profile 2015 Maryland Maryland Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER MARYLANDERS

30-Day Binge Drinking Among Older Marylanders

Binge drinking, defined as five or more 

drinks for men and four or more drinks for 

women on a single occasion, can lead to 

serious health problems. Such problems 

include neurological damage, cardiovascular 

disease, liver disease, stroke, and poor 

control of diabetes. Binge drinkers are 

more likely to take risks such as driving 

while intoxicated and to experience falls 

and other accidents. Older people have a 

lower tolerance for alcohol. Binge drinking 

decreases with age and occurs more 

frequently among men than it does among 

women. As Exhibit 5 shows, 14.6 percent 

of Maryland men ages 50–64 reported 

binge drinking in the past 30 days, while 

6.6 percent of those in the 65+ group 

reported similar behavior. 

Exhibit 5. Binge Drinking Rates in Maryland by Age 

Group and Sex, 2013

24.6%

14.6% 

6.6%

13.6%

7.8%

3.9%

0%

5%

10%

15%

20%

25%

30%

18 to 49 50 to 64 65+

Male Female

Source: Behavioral Risk Factor Surveillance System (BRFSS), 2013

Illicit Drug Use Among Older Americans

Nationally, the rate of illicit drug use 

among older adults ages 50–64 more 

than doubled from 2002 to 2013. 

This development partially reflects 

the entrance into this age group of 

the baby boom cohort, whose rates 

of illicit drug use have been higher 

than those of older cohorts. Although 

state-specific data are not available, the 

Maryland Behavioral Health Barometer

is available for download from the 

Substance Abuse and Mental Health 

Services Administration (SAMHSA) 

website (www.samhsa.gov/data

/population-data-nsduh

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

50 to 54 55 to 59 60 to 64

Source: National Survey on Drug Use and Health (NSDUH), 2013

Illicit drug use includes illegal drugs and prescription drugs used nonmedically. SAMHSA 

provides a list of drugs included in its survey in the NSDUH methodological summary.

Proportion Using in Past Month

Proportion of Population Engaging in Binge Drinking
4

Maryland Maryland Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Marylanders

In 2012, there were 9,536 admissions 

of Marylanders ages 50 and older to 

substance use disorder (SUD) treatment 

in state-funded treatment programs, a 

rate of 466.8 per 100,000 people ages 

50+. This rate was higher than the 

regional rate and the national average. 

Men made up 70.6 percent of these 

admissions. Of all admissions, 

43.9 percent were White/Caucasian, 

54.1 percent were Black/African 

American, and 2.7 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

39.5% 25.7% 34.7%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Maryland, Region 3, and the United States by Sex, 2012

720.9

462.0

383.2

252.9

154.4

120.3

0

100

200

300

400

500

600

700

800

Maryland Region 3 U.S.

Male Female

Source: Treatment Episode Data Set (TEDS), 20121

1

 TEDS data are collected by states as a condition of the Substance Abuse Prevention and Treatment Block Grant. Guidelines suggest that states report all clients 

admitted to publicly financed treatment; however, states are inconsistent in applying the guidelines. States may structure and implement different quality controls 

over the data. For example, states may collect different categories of information to answer TEDS questions. Information is then “walked over” to TEDS definitions.

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions Among Marylanders Ages 50+ by Insurance Type 

In Maryland, 36.0 percent of older 

adult admissions to SUD treatment 

were uninsured, 25.2 percent had 

Medicaid, 17.4 percent had Medicare, 

and 21.4 percent had private insurance.

SUD Treatment Admissions Among 

Marylanders Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

Data not 

available

Data not 

available

Data not 

available

Exhibit 8 and the accompanying text reflect the type of 

health insurance (if any) clients had at admission; the table 

above represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 

50+ in Maryland, Region 3, and the United States by 

Insurance Type, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of SUD Treatment Admissions of Adults Ages 50+ by Insurance Type

SUD Admission Rate per 100,000 Population
Alabama ALABAMA Profile 2015 Maryland Maryland Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Marylanders Ages 50+

Alcohol was the most frequently cited 

substance used by older Marylanders 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 47.4 percent of admissions 

among those ages 50+. This was lower 

than the regional and national rates.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Maryland, Region 3, and the United States, 

2012

47.4%

50.4%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Maryland Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions for Non-Alcohol Substance Use

Substances other than alcohol were 

cited as the primary substances of 

use for 52.6 percent of older adult 

admissions to publicly funded 

treatment in Maryland.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Maryland, Region 3, 

and the United States, 2012

52.6%

49.6%

37.9%

0%

10%

20%

30%

40%

50%

60%

Maryland Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

Proportion of Treatment Admissions 50+ With Other Primary Substance Use Disorder
6

Maryland Maryland Profile 2016

Drug-Related Emergency Department Visits Involving Pharmaceutical Misuse 

and Abuse by Older Adults

SAMHSA periodically releases reports from the Drug Abuse Warning Network (DAWN). DAWN, discontinued 

in 2011, consisted of a nationwide network of hospital emergency departments (EDs) primarily located in 

large metropolitan areas. DAWN data consist of professional reviews of ED records to determine the extent 

to which alcohol and other substance abuse was involved in ED visits. According to the November 25, 2010, 

DAWN Report:

• In 2004, there were an estimated 115,803 ED visits involving pharmaceutical misuse and abuse by adults 

aged 50 or older; in 2008, there were 256,097 such visits, representing an increase of 121.1 percent 

• One fifth (19.7 percent) of ED visits involving pharmaceutical misuse and abuse among older adults were 

made by persons aged 70 or older 

• Among ED visits made by older adults, pain relievers were the type of pharmaceutical most commonly 

involved (43.5 percent), followed by drugs used to treat anxiety or insomnia (31.8 percent) and 

antidepressants (8.6 percent) 

• Among patients aged 50 or older who visited the ED for pharmaceutical misuse or abuse, more than half 

(52.3 percent) were treated and released, and more than one third (37.5 percent) were admitted to the 

hospital 

Bulleted text in italics above is taken from SAMHSA’s Center for Behavioral Health Statistics and Quality. (2010, November 25). The DAWN Report: Drugrelated emergency department visits involving pharmaceutical misuse and abuse by older adults. Rockville, MD: SAMHSA.

CO-OCCURRING SUBSTANCE USE AND MENTAL DISORDERS

Older Marylanders in SUD Treatment With Co-Occurring Mental Disorders

The national literature shows a strong 

relationship between substance use 

and mental disorders. Studies show 

that 30–80 percent of individuals with 

a substance use or mental disorder 

also have a co-occurring disorder. 

Exhibit 11 shows the proportion of SUD 

treatment admissions of Marylanders 

ages 50+ with a co-occurring mental 

disorder. This rate is higher than the 

regional rate and the national average. 

However, state reporting practices are 

a factor in these results.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Maryland, Region 3, 

and the United States, 2012

45.1%

43.6%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Maryland Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders
Alabama ALABAMA Profile 2015 Maryland Maryland Profile 2016

7

MENTAL HEALTH

Older Marylanders Reporting Frequent Mental Distress

BRFSS, a household survey conducted in 

all 50 states and several territories, asks 

the following question: “Now thinking 

about your mental health, which includes 

stress, depression, and problems with 

emotions, for how many days during the 

past 30 days was your mental health not 

good?” Those individuals reporting 14 

or more “Yes” days in response to this 

question experience frequent mental 

distress (FMD). Exhibit 12 shows that 

older Marylanders experience FMD at a 

rate that is lower than the regional and 

national rates. 

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Maryland, Region 3, and the United States, 2013

10.9%

10.5%

6.3%

12.7%

12.3%

7.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

Maryland Region 3 U.S.

Source: BRFSS, 2013

Older Marylanders Reporting Frequent Mental Distress by Age Group and Sex

Older men in Maryland were more likely 

to indulge in binge drinking, but older 

women were more likely to report that 

they had FMD (14 days or more per 

30-day period). As Exhibit 13 shows, 

12.6 percent of women in the 50–64 age 

group and 7.0 percent in the 65+ age 

group reported FMD, while 8.3 percent 

of men in the 50–64 age group and 

5.4 percent in the 65+ age group 

reported FMD.

Exhibit 13. Marylanders Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

9.6%

12.1%

8.3%

12.6%

5.4%

7.0%

0%

2%

4%

6%

8%

10%

12%

14%

Male Female

18 to 49 50 to 64 65+

Source: BRFSS, 2013

Proportion Reporting Frequent Mental Distress

Proportion Reporting Frequent Mental Distress
8

Maryland Maryland Profile 2016

Other Measures of Mental Health

BRFSS collected other measures showing risk factors for mental and/or physical illness. These included:

• Social and Emotional Support (2010). BRFSS asked, “How often do you get the social and emotional 

support you need?” The possible responses were always, usually, sometimes, rarely, or never. 

• Life Satisfaction (2010). BRFSS asked, “In general, how satisfied are you with your life?” The possible 

responses were very satisfied, satisfied, dissatisfied, or very dissatisfied.

Exhibit 14 presents the results of these surveys among older Marylanders.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 8.1% 7.1% 9.6%

Dissatisfied or very 

dissatisfied 5.0% 5.2% 4.8%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical 

health.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Source: BRFSS, 2013

Proportion Reporting Poor Physical Health
Alabama ALABAMA Profile 2015 Maryland Maryland Profile 2016

9

Relationship Among Mental Distress, Diabetes, Stroke, Heart Attack, 

High Blood Pressure, and Coronary Disease

Older Americans who experience FMD 

are more likely to report that they have 

health problems. People with FMD 

were more than twice as likely to report 

having a stroke than those with some 

or no mental distress. They experienced 

coronary disease and heart attack at 

more than 1.6 times, diabetes at more 

than 1.4 times, and high blood pressure 

at nearly 1.2 times the rate of those with 

some or no mental distress.

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

10.1%

13.3% 13.2%

25.9%

60.6%

4.7%

7.6% 7.8%

17.7%

51.1%

0%

10%

20%

30%

40%

50%

60%

70%

Stroke Coronary disease Heart attack Diabetes High blood pressure

Frequent mental distress Some or no mental distress

Source: BRFSS, 2013

Older Marylanders Admitted to State Mental Health Services

Approximately 1.1 percent of the people served by the Maryland mental health system were ages 65 and 

older. This represents more than 1,850 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014 Proportion Reporting Health Problems by Mental Health Category
10 Maryland Maryland Profile 2016

DATA SOURCES

BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (www.cdc.gov/brfss). BRFSS, managed by CDC, 

is the largest ongoing telephone health survey system in the world, tracking health conditions and risk 

behaviors in the United States annually since 1984. Data are collected on a monthly basis in all 50 states, 

the District of Columbia, and participating territories. BRFSS data are collected by local jurisdictions and 

reported to CDC.

CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL CENTER FOR HEALTH 

STATISTICS, UNDERLYING CAUSE OF DEATH 1999-2013 ON CDC WONDER ONLINE DATABASE, 

RELEASED 2015 (http://wonder.cdc.gov/ucd-icd10.html). The WONDER online database “contains 

mortality and population counts for all U.S. counties. Data are based on death certificates for U.S. 

residents. Each death certificate identifies a single underlying cause of death and demographic data. 

The number of deaths, crude death rates or age-adjusted death rates, and 95% confidence intervals 

and standard errors for death rates can be obtained by place of residence (total U.S., region, state and 

county), age group (single-year-of age, 5-year age groups, 10-year age groups and infant age groups), 

race, Hispanic ethnicity, gender, year, cause-of-death (4-digit ICD-10 code or group of codes), injury 

intent and injury mechanism, drug/alcohol induced causes and urbanization categories. Data are also 

available for place of death, month and week day of death, and whether an autopsy was performed.”

CENTER FOR MENTAL HEALTH SERVICES UNIFORM REPORTING SYSTEM (www.samhsa.gov/data

/us_map). States that receive CMHS Block Grants are required to report aggregate data to URS. URS 

reports include information about utilization of mental health services and client demographic and 

outcome information.

NATIONAL SURVEY ON DRUG USE AND HEALTH (https://nsduhweb.rti.org). The NSDUH, managed 

by SAMHSA, is “an annual nationwide survey involving interviews with approximately 70,000 randomly 

selected individuals aged 12 and older.” NSDUH data are most frequently used by state planners 

to assess the need for SUD treatment. NSDUH data also include information about mental health 

conditions.

TREATMENT EPISODE DATA SET (www.samhsa.gov/data/client-level-data-teds/reports?tab=19). States 

that receive Substance Abuse Prevention and Treatment Block Grant funds submit individual client data 

to TEDS. TEDS includes both admission and discharge data sets, and some 1.5 million admissions are 

reported annually. TEDS includes information about utilization of SUD treatment services and client 

demographic and outcome information. TEDS is an admission-based system, and TEDS admissions do 

not represent individuals. Thus, an individual admitted to treatment twice within a calendar year would 

be counted as two admissions.

U.S. CENSUS BUREAU (www.census.gov/people). Two main sources of Census Bureau data were used 

in this report: (1) population estimates and (2) population projections.
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

Pennsylvania
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

August 2016

PENNSYLVANIA’S POPULATION

Pennsylvania Population by Age Group

Pennsylvania is home to 12,787,209 people. 

Of these:

• 4,851,157 (37.9 percent) are over age 50.

• 2,953,705 (23.1 percent) are over age 60.

• 1,470,225 (11.5 percent) are over age 70.

• 618,011 (4.8 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 63.9 percent of the 80+ group. 

The racial/ethnic composition of older 

Pennsylvanians is as follows:

Race/Ethnicity of Pennsylvanians 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

88.8% 0.2% 8.4% 2.0% 0.0% 0.6% 2.8%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

NH/PI stands for Native Hawaiian and Other Pacific Islander.

Exhibit 1. Pennsylvania Population by Age Group, 

2014

744 818 872

760 815

929

711

381

223

711

785

846

757

828

968

773

472

395

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

0 to 9 10 to 19 20 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 to 79 80+

Source: U.S. Census Bureau, 2015

The Number of Older Pennsylvanians Is Growing

The proportion of Pennsylvania’s 

population that is 65 and older is 

growing while the proportion that 

is younger than 65 is shrinking. The 

U.S. Census Bureau estimates that 

22.6 percent of Pennsylvania’s population will be 65 and older by the year 

2030, an increase of 34.5 percent from 

2015.

Projected Population in Pennsylvania

Age Group 2015 2025 2030

Under 18 21.6% 21.7% 21.5%

18 to 44 34.1% 33.0% 32.2%

45 to 64 27.4% 24.3% 23.6%

65+ 16.9% 21.0% 22.6%

Source: U.S. Census Bureau, 2005

Pennsylvania

Exhibit 2. Pennsylvania Population by Age Group, 

2000–2030

Male Female

Population in 1,000s

Population in 1,000s

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

5,000

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+
2

Pennsylvania Pennsylvania Profile 2016

SUICIDE AMONG OLDER PENNSYLVANIANS

Pennsylvania Suicide Rate Compared With Regional and National Rates

The suicide rate among Pennsylvanians 

ages 50 and older is higher than the rate 

among younger age groups. In 2013, the 

total suicide rate among all people ages 

50+ was 18.2 per 100,000 people (6.7 

for women and 31.7 for men). The rate 

among those ages 50–64 was higher than 

both the rate in the region (including 

Delaware, the District of Columbia, 

Maryland, Virginia, and West Virginia) 

and the rate in the United States. 

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in Pennsylvania, Region 3, and 

the United States, 2013

14.0

11.5

20.0

16.0

12.9

10.5

18.5

15.2

13.0

10.6

19.0

16.1

0

5

10

15

20

25

All Under 50 50 to 64 65+

Pennsylvania Region 3 U.S.

Source: Centers for Disease Control and Prevention (CDC), National Center 

for Health Statistics (NCHS), Underlying Cause of Death 1999-2013 on CDC 

WONDER Online Database, released 2015

Trends in Suicide Rates in Pennsylvania

The suicide rate among Pennsylvanians 

ages 50+ fluctuated from a low of 

13.1 per 100,000 in 2004 to a high of 

18.2 per 100,000 in 2013. From 2004 

to 2013, the rate was highest among 

those in the 50–64 age group. 

How a state reports suicides can vary 

from year to year. The number of 

suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

Exhibit 4. Trends in Suicide Rates in Pennsylvania by Age 

Group, 2004–2013

0

5

10

15

20

25

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Source: CDC, NCHS, Underlying Cause of Death 1999-2013 on CDC WONDER 

Online Database, released 2015

Suicide Rate per 100,000 Population

Suicide Rate per 100,000 Population
Alabama ALABAMA Profile 2015 Pennsylvania Pennsylvania Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER PENNSYLVANIANS

30-Day Binge Drinking Among Older Pennsylvanians

Binge drinking, defined as five or more 

drinks for men and four or more drinks 

for women on a single occasion, can 

lead to serious health problems. Such 

problems include neurological damage, 

cardiovascular disease, liver disease, 

stroke, and poor control of diabetes. 

Binge drinkers are more likely to take risks 

such as driving while intoxicated and to 

experience falls and other accidents. Older 

people have a lower tolerance for alcohol. 

Binge drinking decreases with age and 

occurs more frequently among men than 

it does among women. As Exhibit 5 shows, 

17.8 percent of Pennsylvania men ages 

50–64 reported binge drinking in the past 

30 days, while 7.8 percent of those in the 

65+ group reported similar behavior. 

Exhibit 5. Binge Drinking Rates in Pennsylvania by Age 

Group and Sex, 2013

33.4%

17.8% 

7.8%

17.0%

7.0%

2.3% 0%

5%

10%

15%

20%

25%

30%

35%

40%

18 to 49 50 to 64 65+

Male Female

Source: Behavioral Risk Factor Surveillance System (BRFSS), 2013

Illicit Drug Use Among Older Americans

Nationally, the rate of illicit drug use 

among older adults ages 50–64 more 

than doubled from 2002 to 2013. 

This development partially reflects 

the entrance into this age group of 

the baby boom cohort, whose rates 

of illicit drug use have been higher 

than those of older cohorts. Although 

state-specific data are not available, 

the Pennsylvania Behavioral Health 

Barometer is available for download 

from the Substance Abuse and 

Mental Health Services Administration 

(SAMHSA) website (www.samhsa.gov

/data/population-data-nsduh

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

50 to 54 55 to 59 60 to 64

Source: National Survey on Drug Use and Health (NSDUH), 2013

Illicit drug use includes illegal drugs and prescription drugs used nonmedically. SAMHSA 

provides a list of drugs included in its survey in the NSDUH methodological summary.

Proportion Using in Past Month

Proportion of Population Engaging in Binge Drinking
4

Pennsylvania Pennsylvania Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Adults in Region 3

Treatment Episode Data Set (TEDS) data 

for Pennsylvania in 2012 are unavailable. 

Therefore, data for Region 3 are used 

instead. 

In 2012, there were 15,911 admissions of 

individuals in Region 3 ages 50 and older to 

substance use disorder (SUD) treatment in 

state-funded treatment programs, a rate of 

296.3 per 100,000 people ages 50+. This rate 

was higher than the national average. Men 

made up 71.9 percent of these admissions. 

Of all admissions, 42.5 percent were White/

Caucasian, 54.7 percent were Black/African 

American, and 3.0 percent were Hispanic. 

The principal sources of referral to 

treatment among those ages 50 and older 

were: 

Self-Referral Criminal Justice Other

38.9% 25.9% 35.3%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Region 3 and the United States by Sex, 2012

462.0

383.2

154.4

120.3

0

50

100

150

200

250

300

350

400

450

500

Region 3 U.S.

Male Female

Source: Treatment Episode Data Set (TEDS), 20121

1

 TEDS data are collected by states as a condition of the Substance Abuse Prevention and Treatment Block Grant. Guidelines suggest that states report all clients 

admitted to publicly financed treatment; however, states are inconsistent in applying the guidelines. States may structure and implement different quality controls 

over the data. For example, states may collect different categories of information to answer TEDS questions. Information is then “walked over” to TEDS definitions.

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions Among Individuals in Region 3 Ages 50+ by 

Insurance Type

TEDS data for Pennsylvania in 2012 are 

unavailable. Therefore, data for Region 3 

are used instead.

In Region 3, 33.9 percent of older 

adult admissions to SUD treatment 

were uninsured, 32.4 percent had 

Medicaid, 17.0 percent had Medicare, 

and 16.7 percent had private insurance.

SUD Treatment Admissions Among 

Pennsylvanians Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

Data not 

available

Data not 

available

Data not 

available

Exhibit 8 and the accompanying text reflect the type of 

health insurance (if any) clients had at admission; the table 

above represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ in 

Region 3 and the United States by Insurance Type, 2012

16.7%

32.4%

17.0%

33.9%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

Private Medicaid Medicare None

Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of SUD Treatment Admissions of Adults Ages 50+ by Insurance Type

SUD Admission Rate per 100,000 Population
Alabama ALABAMA Profile 2015 Pennsylvania Pennsylvania Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Individuals in Region 3 

Ages 50+

TEDS data for Pennsylvania in 2012 

are unavailable. Therefore, data for 

Region 3 are used instead.

Alcohol was the most frequently cited 

substance used by older individuals 

in Region 3 in publicly financed SUD 

treatment in 2012. It was mentioned 

as a substance of use in 50.4 percent 

of admissions among those ages 50+. 

This was lower than the national rate.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Region 3 and the United States, 2012

50.4%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions for Non-Alcohol Substance Use in Region 3

TEDS data for Pennsylvania in 2012 

are unavailable. Therefore, data for 

Region 3 are used instead.

Substances other than alcohol were 

cited as the primary substances of 

use for 49.6 percent of older adult 

admissions to publicly funded 

treatment in Region 3.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Region 3 and the 

United States, 2012

49.6%

37.9%

0%

10%

20%

30%

40%

50%

60%

Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

Proportion of Treatment Admissions 50+ With Other Primary Substance Use Disorder
6

Pennsylvania Pennsylvania Profile 2016

Drug-Related Emergency Department Visits Involving Pharmaceutical Misuse 

and Abuse by Older Adults

SAMHSA periodically releases reports from the Drug Abuse Warning Network (DAWN). DAWN, discontinued 

in 2011, consisted of a nationwide network of hospital emergency departments (EDs) primarily located in 

large metropolitan areas. DAWN data consist of professional reviews of ED records to determine the extent 

to which alcohol and other substance abuse was involved in ED visits. According to the November 25, 2010, 

DAWN Report:

• In 2004, there were an estimated 115,803 ED visits involving pharmaceutical misuse and abuse by adults 

aged 50 or older; in 2008, there were 256,097 such visits, representing an increase of 121.1 percent 

• One fifth (19.7 percent) of ED visits involving pharmaceutical misuse and abuse among older adults were 

made by persons aged 70 or older 

• Among ED visits made by older adults, pain relievers were the type of pharmaceutical most commonly 

involved (43.5 percent), followed by drugs used to treat anxiety or insomnia (31.8 percent) and 

antidepressants (8.6 percent) 

• Among patients aged 50 or older who visited the ED for pharmaceutical misuse or abuse, more than half 

(52.3 percent) were treated and released, and more than one third (37.5 percent) were admitted to the 

hospital 

Bulleted text in italics above is taken from SAMHSA’s Center for Behavioral Health Statistics and Quality. (2010, November 25). The DAWN Report: Drugrelated emergency department visits involving pharmaceutical misuse and abuse by older adults. Rockville, MD: SAMHSA.

CO-OCCURRING SUBSTANCE USE AND MENTAL DISORDERS

Older Adults in Region 3 in SUD Treatment With Co-Occurring Mental Disorders

The national literature shows a strong 

relationship between substance use 

and mental disorders. Studies show 

that 30–80 percent of individuals with 

a substance use or mental disorder 

also have a co-occurring disorder.

TEDS data for Pennsylvania in 2012 

are unavailable. Therefore, Exhibit 11 

shows regional and national figures 

only.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Region 3 and the 

United States, 2012

43.6%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders
Alabama ALABAMA Profile 2015 Pennsylvania Pennsylvania Profile 2016

7

MENTAL HEALTH

Older Pennsylvanians Reporting Frequent Mental Distress

BRFSS, a household survey conducted in 

all 50 states and several territories, asks 

the following question: “Now thinking 

about your mental health, which includes 

stress, depression, and problems with 

emotions, for how many days during the 

past 30 days was your mental health not 

good?” Those individuals reporting 14 

or more “Yes” days in response to this 

question experience frequent mental 

distress (FMD). Exhibit 12 shows that 

older Pennsylvanians experience FMD 

at a rate that is higher than the regional 

rate and roughly similar to the national 

rate. 

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Pennsylvania, Region 3, and the United States, 2013

14.2%

12.7%

7.5%

12.7% 12.3%

7.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18 to 49 50 to 64 65+

Pennsylvania Region 3 U.S.

Source: BRFSS, 2013

Older Pennsylvanians Reporting Frequent Mental Distress by Age Group 

and Sex

Older men in Pennsylvania were more 

likely to indulge in binge drinking, but 

older women were more likely to report 

that they had FMD (14 days or more 

per 30-day period). As Exhibit 13 shows, 

14.6 percent of women in the 50–64 age 

group and 7.5 percent in the 65+ age 

group reported FMD, while 10.8 percent 

of men in the 50–64 age group and 

7.4 percent in the 65+ age group 

reported FMD.

Exhibit 13. Pennsylvanians Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

12.0%

16.5%

10.8%

14.6%

7.4% 7.5%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

Male Female

18 to 49 50 to 64 65+

Source: BRFSS, 2013

Proportion Reporting Frequent Mental Distress

Proportion Reporting Frequent Mental Distress
8

Pennsylvania Pennsylvania Profile 2016

Other Measures of Mental Health

BRFSS collected other measures showing risk factors for mental and/or physical illness. These included:

• Social and Emotional Support (2010). BRFSS asked, “How often do you get the social and emotional 

support you need?” The possible responses were always, usually, sometimes, rarely, or never. 

• Life Satisfaction (2010). BRFSS asked, “In general, how satisfied are you with your life?” The possible 

responses were very satisfied, satisfied, dissatisfied, or very dissatisfied.

Exhibit 14 presents the results of these surveys among older Pennsylvanians.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 9.6% 7.4% 12.4%

Dissatisfied or very 

dissatisfied 5.0% 6.1% 3.6%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical 

health.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Source: BRFSS, 2013

Proportion Reporting Poor Physical Health
Alabama ALABAMA Profile 2015 Pennsylvania Pennsylvania Profile 2016

9

Relationship Among Mental Distress, Diabetes, Stroke, Heart Attack, 

High Blood Pressure, and Coronary Disease

Older Americans who experience FMD 

are more likely to report that they have 

health problems. People with FMD 

were more than twice as likely to report 

having a stroke than those with some 

or no mental distress. They experienced 

coronary disease and heart attack at 

more than 1.6 times, diabetes at more 

than 1.4 times, and high blood pressure 

at nearly 1.2 times the rate of those with 

some or no mental distress.

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

10.1%

13.3% 13.2%

25.9%

60.6%

4.7%

7.6% 7.8%

17.7%

51.1%

0%

10%

20%

30%

40%

50%

60%

70%

Stroke Coronary disease Heart attack Diabetes High blood pressure

Frequent mental distress Some or no mental distress

Source: BRFSS, 2013

Older Pennsylvanians Admitted to State Mental Health Services

Approximately 3.7 percent of the people served by the Pennsylvania mental health system were ages 65 

and older. This represents more than 22,820 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014 Proportion Reporting Health Problems by Mental Health Category
10 Pennsylvania Pennsylvania Profile 2016

DATA SOURCES

BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (www.cdc.gov/brfss). BRFSS, managed by CDC, 

is the largest ongoing telephone health survey system in the world, tracking health conditions and risk 

behaviors in the United States annually since 1984. Data are collected on a monthly basis in all 50 states, 

the District of Columbia, and participating territories. BRFSS data are collected by local jurisdictions and 

reported to CDC.

CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL CENTER FOR HEALTH 

STATISTICS, UNDERLYING CAUSE OF DEATH 1999-2013 ON CDC WONDER ONLINE DATABASE, 

RELEASED 2015 (http://wonder.cdc.gov/ucd-icd10.html). The WONDER online database “contains 

mortality and population counts for all U.S. counties. Data are based on death certificates for U.S. 

residents. Each death certificate identifies a single underlying cause of death and demographic data. 

The number of deaths, crude death rates or age-adjusted death rates, and 95% confidence intervals 

and standard errors for death rates can be obtained by place of residence (total U.S., region, state and 

county), age group (single-year-of age, 5-year age groups, 10-year age groups and infant age groups), 

race, Hispanic ethnicity, gender, year, cause-of-death (4-digit ICD-10 code or group of codes), injury 

intent and injury mechanism, drug/alcohol induced causes and urbanization categories. Data are also 

available for place of death, month and week day of death, and whether an autopsy was performed.”

CENTER FOR MENTAL HEALTH SERVICES UNIFORM REPORTING SYSTEM (www.samhsa.gov/data

/us_map). States that receive CMHS Block Grants are required to report aggregate data to URS. URS 

reports include information about utilization of mental health services and client demographic and 

outcome information.

NATIONAL SURVEY ON DRUG USE AND HEALTH (https://nsduhweb.rti.org). The NSDUH, managed 

by SAMHSA, is “an annual nationwide survey involving interviews with approximately 70,000 randomly 

selected individuals aged 12 and older.” NSDUH data are most frequently used by state planners 

to assess the need for SUD treatment. NSDUH data also include information about mental health 

conditions.

TREATMENT EPISODE DATA SET (www.samhsa.gov/data/client-level-data-teds/reports?tab=19). States 

that receive Substance Abuse Prevention and Treatment Block Grant funds submit individual client data 

to TEDS. TEDS includes both admission and discharge data sets, and some 1.5 million admissions are 

reported annually. TEDS includes information about utilization of SUD treatment services and client 

demographic and outcome information. TEDS is an admission-based system, and TEDS admissions do 

not represent individuals. Thus, an individual admitted to treatment twice within a calendar year would 

be counted as two admissions.

U.S. CENSUS BUREAU (www.census.gov/people). Two main sources of Census Bureau data were used 

in this report: (1) population estimates and (2) population projections.
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

Virginia
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

August 2016

VIRGINIA’S POPULATION

Virginia Population by Age Group

Virginia is home to 8,326,289 people. 

Of these:

• 2,796,109 (33.6 percent) are over age 50.

• 1,623,093 (19.5 percent) are over age 60.

• 750,055 (9.0 percent) are over age 70.

• 274,188 (3.3 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 62.9 percent of the 80+ group. 

The racial/ethnic composition of older 

Virginians is as follows:

Race/Ethnicity of Virginians 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

76.3% 0.4% 17.4% 4.8% 0.1% 1.0% 3.9%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

NH/PI stands for Native Hawaiian and Other Pacific Islander.

Exhibit 1. Virginia Population by Age Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older Virginians Is Growing

The proportion of Virginia’s population 

that is 65 and older is growing while 

the proportion that is younger than 65 

is shrinking. The U.S. Census Bureau 

estimates that 18.8 percent of Virginia’s 

population will be 65 and older by the 

year 2030, an increase of 54.5 percent 

from 2015.

Projected Population in Virginia

Age Group 2015 2025 2030

Under 18 23.4% 23.6% 23.6%

18 to 44 36.4% 35.9% 35.9%

45 to 64 26.1% 23.0% 21.7%

65+ 14.1% 17.4% 18.8%

Source: U.S. Census Bureau, 2005

Virginia

Exhibit 2. Virginia Population by Age Group, 2000–2030 Population in 1,000s

Population in 1,000s

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+
2

Virginia Virginia Profile 2016

SUICIDE AMONG OLDER VIRGINIANS

Virginia Suicide Rate Compared With Regional and National Rates

The suicide rate among Virginians ages 

50 and older is higher than the rate 

among younger age groups. In 2013, 

the total suicide rate among all people 

ages 50+ was 17.4 per 100,000 people 

(6.6 for women and 29.8 for men). 

The rate among those ages 50–64 was 

lower than both the rate in the region 

(including Delaware, the District of 

Columbia, Maryland, Pennsylvania, and 

West Virginia) and the rate in the United 

States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in Virginia, Region 3, and the 

United States, 2013

13.0

10.8

18.0

16.5

12.9

10.5

18.5

15.2

13.0

10.6

19.0

16.1

0

2

4

6

8

10

12

14

16

18

20

All Under 50 50 to 64 65+

Virginia Region 3 U.S.

Source: Centers for Disease Control and Prevention (CDC), National Center 

for Health Statistics (NCHS), Underlying Cause of Death 1999-2013 on CDC 

WONDER Online Database, released 2015

Trends in Suicide Rates in Virginia

The suicide rate among Virginians 

ages 50+ fluctuated from a low of 

15.5 per 100,000 in 2007 to a high of 

18.6 per 100,000 in 2011. From 2004 

to 2013, the rate was highest among 

those in the 50–64 and 65+ age 

groups.

How a state reports suicides can vary 

from year to year. The number of 

suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

Exhibit 4. Trends in Suicide Rates in Virginia by Age Group, 

2004–2013

Suicide Rate per 100,000 Population

Suicide Rate per 100,000 Population

0

2

4

6

8

10

12

14

16

18

20

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Source: CDC, NCHS, Underlying Cause of Death 1999-2013 on CDC WONDER 

Online Database, released 2015
Alabama ALABAMA Profile 2015 Virginia Virginia Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER VIRGINIANS

30-Day Binge Drinking Among Older Virginians

Binge drinking, defined as five or more 

drinks for men and four or more drinks 

for women on a single occasion, can 

lead to serious health problems. Such 

problems include neurological damage, 

cardiovascular disease, liver disease, 

stroke, and poor control of diabetes. 

Binge drinkers are more likely to take risks 

such as driving while intoxicated and to 

experience falls and other accidents. Older 

people have a lower tolerance for alcohol. 

Binge drinking decreases with age and 

occurs more frequently among men than 

it does among women. As Exhibit 5 shows, 

12.9 percent of Virginia men ages 50–64 

reported binge drinking in the past 

30 days, while 7.5 percent of those in the 

65+ group reported similar behavior. 

Exhibit 5. Binge Drinking Rates in Virginia by Age Group 

and Sex, 2013

30.4%

12.9% 

7.5%

15.0%

7.0%

2.2% 0%

5%

10%

15%

20%

25%

30%

35%

18 to 49 50 to 64 65+

Male Female

Source: Behavioral Risk Factor Surveillance System (BRFSS), 2013

Illicit Drug Use Among Older Americans

Nationally, the rate of illicit drug use 

among older adults ages 50–64 more 

than doubled from 2002 to 2013. 

This development partially reflects 

the entrance into this age group of 

the baby boom cohort, whose rates 

of illicit drug use have been higher 

than those of older cohorts. Although 

state-specific data are not available, the 

Virginia Behavioral Health Barometer

is available for download from the 

Substance Abuse and Mental Health 

Services Administration (SAMHSA) 

website (www.samhsa.gov/data

/population-data-nsduh

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

50 to 54 55 to 59 60 to 64

Source: National Survey on Drug Use and Health (NSDUH), 2013

Illicit drug use includes illegal drugs and prescription drugs used nonmedically. SAMHSA 

provides a list of drugs included in its survey in the NSDUH methodological summary.

Proportion Using in Past Month

Proportion of Population Engaging in Binge Drinking
4

Virginia Virginia Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Virginians

In 2012, there were 3,713 admissions 

of Virginians ages 50 and older to 

substance use disorder (SUD) treatment 

in state-funded treatment programs, 

a rate of 132.8 per 100,000 people 

ages 50+. This rate was lower than the 

regional rate and the national average. 

Men made up 72.7 percent of these 

admissions. Of all admissions, 56.5 

percent were White/Caucasian, 38.2 

percent were Black/African American, 

and 3.4 percent were Hispanic. 

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

39.4% 36.4% 24.1%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Virginia, Region 3, and the United States by Sex, 2012

207.0

462.0

383.2

67.7

154.4

120.3

0

50

100

150

200

250

300

350

400

450

500

Virginia Region 3 U.S.

Male Female

Source: Treatment Episode Data Set (TEDS), 20121

1

 TEDS data are collected by states as a condition of the Substance Abuse Prevention and Treatment Block Grant. Guidelines suggest that states report all clients 

admitted to publicly financed treatment; however, states are inconsistent in applying the guidelines. States may structure and implement different quality controls 

over the data. For example, states may collect different categories of information to answer TEDS questions. Information is then “walked over” to TEDS definitions.

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions Among Individuals in Region 3 Ages 50+ by 

Insurance Type

States may choose not to report some of 

the fields to TEDS, including information 

on treatment admission insurance types. 

These data were not reported by Virginia 

in 2012. Therefore, the rates for Region 3 

are used instead.

In Region 3, 33.9 percent of older 

adult admissions to SUD treatment were 

uninsured, 32.4 percent had Medicaid, 

17.0 percent had Medicare, and 

16.7 percent had private insurance.

SUD Treatment Admissions Among 

Virginians Ages 50+ by Primary Sources 

of Payment

Self-Pay Medicaid Other

Data not 

available

Data not 

available

Data not 

available

Exhibit 8 and the accompanying text reflect the type of health 

insurance (if any) clients had at admission; the table above 

represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Region 3 and the United States by Insurance Type, 2012

16.7%

32.4%

17.0%

33.9%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

Private Medicaid Medicare None

Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of SUD Treatment Admissions of Adults Ages 50+ by Insurance Type

SUD Admission Rate per 100,000 Population
Alabama ALABAMA Profile 2015 Virginia Virginia Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Virginians Ages 50+

Alcohol was the most frequently cited 

substance used by older Virginians in 

publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 64.4 percent of admissions 

among those ages 50+. This was 

higher than the regional and national 

rates.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Virginia, Region 3, and the United States, 

2012

64.4%

50.4%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Virginia Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions for Non-Alcohol Substance Use

Substances other than alcohol were 

cited as the primary substances of 

use for 35.6 percent of older adult 

admissions to publicly funded 

treatment in Virginia.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Virginia, Region 3, 

and the United States, 2012

35.6%

49.6%

37.9%

0%

10%

20%

30%

40%

50%

60%

Virginia Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

Proportion of Treatment Admissions 50+ With Other Primary Substance Use Disorder
6

Virginia Virginia Profile 2016

Drug-Related Emergency Department Visits Involving Pharmaceutical Misuse 

and Abuse by Older Adults

SAMHSA periodically releases reports from the Drug Abuse Warning Network (DAWN). DAWN, discontinued 

in 2011, consisted of a nationwide network of hospital emergency departments (EDs) primarily located in 

large metropolitan areas. DAWN data consist of professional reviews of ED records to determine the extent 

to which alcohol and other substance abuse was involved in ED visits. According to the November 25, 2010, 

DAWN Report:

• In 2004, there were an estimated 115,803 ED visits involving pharmaceutical misuse and abuse by adults 

aged 50 or older; in 2008, there were 256,097 such visits, representing an increase of 121.1 percent 

• One fifth (19.7 percent) of ED visits involving pharmaceutical misuse and abuse among older adults were 

made by persons aged 70 or older 

• Among ED visits made by older adults, pain relievers were the type of pharmaceutical most commonly 

involved (43.5 percent), followed by drugs used to treat anxiety or insomnia (31.8 percent) and 

antidepressants (8.6 percent) 

• Among patients aged 50 or older who visited the ED for pharmaceutical misuse or abuse, more than half 

(52.3 percent) were treated and released, and more than one third (37.5 percent) were admitted to the 

hospital 

Bulleted text in italics above is taken from SAMHSA’s Center for Behavioral Health Statistics and Quality. (2010, November 25). The DAWN Report: Drugrelated emergency department visits involving pharmaceutical misuse and abuse by older adults. Rockville, MD: SAMHSA.

CO-OCCURRING SUBSTANCE USE AND MENTAL DISORDERS

Older Adults in Region 3 in SUD Treatment With Co-Occurring Mental Disorders

The national literature shows a strong 

relationship between substance use 

and mental disorders. Studies show 

that 30–80 percent of individuals with a 

substance use or mental disorder also 

have a co-occurring disorder.

States may choose not to report 

some of the fields to TEDS, including 

information on SUD treatment 

admissions with a co-occurring 

disorder. These data were not reported 

by Virginia in 2012. Therefore, 

Exhibit 11 shows regional and 

national figures only.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Region 3 and the 

United States, 2012

43.6%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders
Alabama ALABAMA Profile 2015 Virginia Virginia Profile 2016

7

MENTAL HEALTH

Older Virginians Reporting Frequent Mental Distress

BRFSS, a household survey conducted in 

all 50 states and several territories, asks 

the following question: “Now thinking 

about your mental health, which includes 

stress, depression, and problems with 

emotions, for how many days during the 

past 30 days was your mental health not 

good?” Those individuals reporting 14 

or more “Yes” days in response to this 

question experience frequent mental 

distress (FMD). Exhibit 12 shows that 

older Virginians experience FMD at a 

rate that is lower than the regional and 

national rates. 

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Virginia, Region 3, and the United States, 2013

11.3% 11.2%

6.6%

12.7%

12.3%

7.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

Virginia Region 3 U.S.

Source: BRFSS, 2013

Older Virginians Reporting Frequent Mental Distress by Age Group and Sex

As Exhibit 13 shows, in Virginia, 

8.5 percent of men in the 50–64 age 

group reported FMD (14 days or more 

per 30-day period) compared with 

13.8 percent of women in this age 

group. Men in the 65+ age group 

reported a higher rate of FMD than 

women in the same age group 

(7.6 percent compared with 5.8 percent). 

The District of Columbia is the only 

other state-level jurisdiction in the 

region where men in the 65+ age group 

reported a higher rate of FMD than did 

women in this age group.

Exhibit 13. Virginians Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

9.6%

13.1%

8.5%

13.8%

7.6%

5.8%

0%

2%

4%

6%

8%

10%

12%

14%

16%

Male Female

18 to 49 50 to 64 65+

Source: BRFSS, 2013

Proportion Reporting Frequent Mental Distress

Proportion Reporting Frequent Mental Distress
8

Virginia Virginia Profile 2016

Other Measures of Mental Health

BRFSS collected other measures showing risk factors for mental and/or physical illness. These included:

• Social and Emotional Support (2010). BRFSS asked, “How often do you get the social and emotional 

support you need?” The possible responses were always, usually, sometimes, rarely, or never. 

• Life Satisfaction (2010). BRFSS asked, “In general, how satisfied are you with your life?” The possible 

responses were very satisfied, satisfied, dissatisfied, or very dissatisfied.

Exhibit 14 presents the results of these surveys among older Virginians.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 8.8% 7.7% 10.4%

Dissatisfied or very 

dissatisfied 4.4% 5.1% 3.3%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical 

health.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Source: BRFSS, 2013

Proportion Reporting Poor Physical Health
Alabama ALABAMA Profile 2015 Virginia Virginia Profile 2016

9

Relationship Among Mental Distress, Diabetes, Stroke, Heart Attack, 

High Blood Pressure, and Coronary Disease

Older Americans who experience FMD 

are more likely to report that they have 

health problems. People with FMD 

were more than twice as likely to report 

having a stroke than those with some 

or no mental distress. They experienced 

coronary disease and heart attack at 

more than 1.6 times, diabetes at more 

than 1.4 times, and high blood pressure 

at nearly 1.2 times the rate of those with 

some or no mental distress.

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

10.1%

13.3% 13.2%

25.9%

60.6%

4.7%

7.6% 7.8%

17.7%

51.1%

0%

10%

20%

30%

40%

50%

60%

70%

Stroke Coronary disease Heart attack Diabetes High blood pressure

Frequent mental distress Some or no mental distress

Source: BRFSS, 2013

Older Virginians Admitted to State Mental Health Services

Approximately 4.7 percent of the people served by the Virginia mental health system were ages 65 and 

older. This represents more than 5,310 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014 Proportion Reporting Health Problems by Mental Health Category
10 Virginia Virginia Profile 2016

DATA SOURCES

BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (www.cdc.gov/brfss). BRFSS, managed by CDC, 

is the largest ongoing telephone health survey system in the world, tracking health conditions and risk 

behaviors in the United States annually since 1984. Data are collected on a monthly basis in all 50 states, 

the District of Columbia, and participating territories. BRFSS data are collected by local jurisdictions and 

reported to CDC.

CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL CENTER FOR HEALTH 

STATISTICS, UNDERLYING CAUSE OF DEATH 1999-2013 ON CDC WONDER ONLINE DATABASE, 

RELEASED 2015 (http://wonder.cdc.gov/ucd-icd10.html). The WONDER online database “contains 

mortality and population counts for all U.S. counties. Data are based on death certificates for U.S. 

residents. Each death certificate identifies a single underlying cause of death and demographic data. 

The number of deaths, crude death rates or age-adjusted death rates, and 95% confidence intervals 

and standard errors for death rates can be obtained by place of residence (total U.S., region, state and 

county), age group (single-year-of age, 5-year age groups, 10-year age groups and infant age groups), 

race, Hispanic ethnicity, gender, year, cause-of-death (4-digit ICD-10 code or group of codes), injury 

intent and injury mechanism, drug/alcohol induced causes and urbanization categories. Data are also 

available for place of death, month and week day of death, and whether an autopsy was performed.”

CENTER FOR MENTAL HEALTH SERVICES UNIFORM REPORTING SYSTEM (www.samhsa.gov/data

/us_map). States that receive CMHS Block Grants are required to report aggregate data to URS. URS 

reports include information about utilization of mental health services and client demographic and 

outcome information.

NATIONAL SURVEY ON DRUG USE AND HEALTH (https://nsduhweb.rti.org). The NSDUH, managed 

by SAMHSA, is “an annual nationwide survey involving interviews with approximately 70,000 randomly 

selected individuals aged 12 and older.” NSDUH data are most frequently used by state planners 

to assess the need for SUD treatment. NSDUH data also include information about mental health 

conditions.

TREATMENT EPISODE DATA SET (www.samhsa.gov/data/client-level-data-teds/reports?tab=19). States 

that receive Substance Abuse Prevention and Treatment Block Grant funds submit individual client data 

to TEDS. TEDS includes both admission and discharge data sets, and some 1.5 million admissions are 

reported annually. TEDS includes information about utilization of SUD treatment services and client 

demographic and outcome information. TEDS is an admission-based system, and TEDS admissions do 

not represent individuals. Thus, an individual admitted to treatment twice within a calendar year would 

be counted as two admissions.

U.S. CENSUS BUREAU (www.census.gov/people). Two main sources of Census Bureau data were used 

in this report: (1) population estimates and (2) population projections.
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

West Virginia
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

August 2016

WEST VIRGINIA’S POPULATION

West Virginia Population by Age Group

West Virginia is home to 1,850,326 people. 

Of these:

• 731,224 (39.5 percent) are over age 50.

• 460,005 (24.9 percent) are over age 60.

• 217,284 (11.7 percent) are over age 70.

• 78,952 (4.3 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 62.8 percent of the 80+ group. 

The racial/ethnic composition of older 

West Virginians is as follows:

Race/Ethnicity of West Virginians 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

95.7% 0.2% 2.8% 0.5% 0.0% 0.7% 0.7%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

NH/PI stands for Native Hawaiian and Other Pacific Islander.

Exhibit 1. West Virginia Population by Age Group, 

2014

106 112 119 112 120

133

118

64

29

101 106

114 110

118

138

124

74

50

0

50

100

150

200

250

300

0 to 9 10 to 19 20 to 29 30 to 39 40 to 49 50 to 59 60 to 69 70 to 79 80+

Male Female

Source: U.S. Census Bureau, 2015

The Number of Older West Virginians Is Growing

The proportion of West Virginia’s 

population that is 65 and older is 

growing while the proportion that 

is younger than 65 is shrinking. The 

U.S. Census Bureau estimates that 

24.8 percent of West Virginia’s 

population will be 65 and older by 

the year 2030, an increase of 

29.3 percent from 2015.

Projected Population in West Virginia

Age Group 2015 2025 2030

Under 18 20.4% 19.2% 18.9%

18 to 44 32.7% 30.2% 29.0%

45 to 64 28.8% 27.5% 27.3%

65+ 18.1% 23.1% 24.8%

Source: U.S. Census Bureau, 2005

West Virginia

Exhibit 2. West Virginia Population by Age Group, 

2000–2030

Population in 1,000s

Population in 1,000s

0

100

200

300

400

500

600

700

800

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+
2

West Virginia West Virginia Profile 2016

SUICIDE AMONG OLDER WEST VIRGINIANS

West Virginia Suicide Rate Compared With Regional and National Rates

The suicide rate among West Virginians 

ages 50 and older is higher than the rate 

among younger age groups. In 2013, 

the total suicide rate among all people 

ages 50+ was 22.6 per 100,000 people 

(unreliable data for women and 42.3 for 

men). The rate among those ages 50–64 

was higher than both the rate in the 

region (including Delaware, the District 

of Columbia, Maryland, Pennsylvania, 

and Virginia) and the rate in the United 

States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in West Virginia, Region 3, and 

the United States, 2013

17.4

14.1

23.6

21.2

12.9

10.5

18.5

15.2

13.0

10.6

19.0

16.1

0

5

10

15

20

25

All Under 50 50 to 64 65+

West Virginia Region 3 U.S.

Source: Centers for Disease Control and Prevention (CDC), National Center 

for Health Statistics (NCHS), Underlying Cause of Death 1999-2013 on CDC 

WONDER Online Database, released 2015

Trends in Suicide Rates in West Virginia

The suicide rate among West Virginians 

ages 50+ fluctuated from a low of 15.1 

per 100,000 in 2009 to a high of 22.6 

per 100,000 in 2013. From 2004 to 

2013, the rate was generally highest 

among those in the 50–64 age group. 

How a state reports suicides can vary 

from year to year. The number of 

suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

Exhibit 4. Trends in Suicide Rates in West Virginia by Age 

Group, 2004–2013

Suicide Rate per 100,000 Population

Suicide Rate per 100,000 Population

0

5

10

15

20

25

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Source: CDC, NCHS, Underlying Cause of Death 1999-2013 on CDC WONDER 

Online Database, released 2015
Alabama ALABAMA Profile 2015 West Virginia West Virginia Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER WEST VIRGINIANS

30-Day Binge Drinking Among Older West Virginians

Binge drinking, defined as five or more 

drinks for men and four or more drinks for 

women on a single occasion, can lead to 

serious health problems. Such problems 

include neurological damage, cardiovascular 

disease, liver disease, stroke, and poor 

control of diabetes. Binge drinkers are 

more likely to take risks such as driving 

while intoxicated and to experience falls 

and other accidents. Older people have a 

lower tolerance for alcohol. Binge drinking 

decreases with age and occurs more 

frequently among men than it does among 

women. As Exhibit 5 shows, 13.6 percent 

of West Virginia men ages 50–64 reported 

binge drinking in the past 30 days, while 

4.8 percent of those in the 65+ group 

reported similar behavior. 

Exhibit 5. Binge Drinking Rates in West Virginia by Age 

Group and Sex, 2013

21.7%

13.6% 

4.8%

11.6%

3.7%

0.8%

0%

5%

10%

15%

20%

25%

18 to 49 50 to 64 65+

Male Female

Source: Behavioral Risk Factor Surveillance System (BRFSS), 2013

Illicit Drug Use Among Older Americans

Nationally, the rate of illicit drug use 

among older adults ages 50–64 more 

than doubled from 2002 to 2013. This 

development partially reflects the 

entrance into this age group of the 

baby boom cohort, whose rates of 

illicit drug use have been higher than 

those of older cohorts. Although statespecific data are not available, the West 

Virginia Behavioral Health Barometer 

is available for download from the 

Substance Abuse and Mental Health 

Services Administration (SAMHSA) 

website (www.samhsa.gov/data

/population-data-nsduh

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

50 to 54 55 to 59 60 to 64

Source: National Survey on Drug Use and Health (NSDUH), 2013

Illicit drug use includes illegal drugs and prescription drugs used nonmedically. SAMHSA 

provides a list of drugs included in its survey in the NSDUH methodological summary.

Proportion Using in Past Month

Proportion of Population Engaging in Binge Drinking
4

West Virginia West Virginia Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Adults in Region 3

Treatment Episode Data Set (TEDS) data 

for West Virginia in 2012 are unavailable. 

Therefore, the rates for Region 3 are used 

instead. 

In 2012, there were 15,911 admissions of 

individuals in Region 3 ages 50 and older to 

substance use disorder (SUD) treatment in 

state-funded treatment programs, a rate of 

296.3 per 100,000 people ages 50+. This rate 

was higher than the national average. Men 

made up 71.9 percent of these admissions. 

Of all admissions, 42.5 percent were White/

Caucasian, 54.7 percent were Black/African 

American, and 3.0 percent were Hispanic. 

The principal sources of referral to treatment 

among those ages 50 and older were: 

Self-Referral Criminal Justice Other

38.9% 25.9% 35.3%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Region 3 and the United States by Sex, 2012

462.0

383.2

154.4

120.3

0

50

100

150

200

250

300

350

400

450

500

Region 3 U.S.

Male Female

Source: Treatment Episode Data Set (TEDS), 20121

1

 TEDS data are collected by states as a condition of the Substance Abuse Prevention and Treatment Block Grant. Guidelines suggest that states report all clients 

admitted to publicly financed treatment; however, states are inconsistent in applying the guidelines. States may structure and implement different quality controls 

over the data. For example, states may collect different categories of information to answer TEDS questions. Information is then “walked over” to TEDS definitions.

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions Among Individuals in Region 3 Ages 50+ by 

Insurance Type

TEDS data for West Virginia in 2012 are 

unavailable. Therefore, data for Region 3 

are used instead.

In Region 3, 33.9 percent of older 

adult admissions to SUD treatment 

were uninsured, 32.4 percent had 

Medicaid, 17.0 percent had Medicare, 

and 16.7 percent had private insurance.

SUD Treatment Admissions Among 

West Virginians Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

Data not 

available

Data not 

available

Data not 

available

Exhibit 8 and the accompanying text reflect the type of 

health insurance (if any) clients had at admission; the table 

above represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Region 3 and the United States by Insurance Type, 2012

16.7%

32.4%

17.0%

33.9%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

Private Medicaid Medicare None

Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of SUD Treatment Admissions of Adults Ages 50+ by Insurance Type

SUD Admission Rate per 100,000 Population
Alabama ALABAMA Profile 2015 West Virginia West Virginia Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Individuals in Region 3 

Ages 50+

TEDS data for West Virginia in 2012 

are unavailable. Therefore, data for 

Region 3 are used instead.

Alcohol was the most frequently cited 

substance used by older individuals 

in Region 3 in publicly financed SUD 

treatment in 2012. It was mentioned 

as a substance of use in 50.4 percent 

of admissions among those ages 50+. 

This was lower than the national rate.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Region 3 and the United States, 2012

50.4%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions for Non-Alcohol Substance Use in Region 3

TEDS data for West Virginia in 2012 

are unavailable. Therefore, data for 

Region 3 are used instead.

Substances other than alcohol were 

cited as the primary substances 

of use for 49.6 percent of older 

adult admissions to publicly funded 

treatment in Region 3.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Region 3 and the 

United States, 2012

49.6%

37.9%

0%

10%

20%

30%

40%

50%

60%

Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

Proportion of Treatment Admissions 50+ With Other Primary Substance Use Disorder
6

West Virginia West Virginia Profile 2016

Drug-Related Emergency Department Visits Involving Pharmaceutical Misuse 

and Abuse by Older Adults

SAMHSA periodically releases reports from the Drug Abuse Warning Network (DAWN). DAWN, discontinued 

in 2011, consisted of a nationwide network of hospital emergency departments (EDs) primarily located in 

large metropolitan areas. DAWN data consist of professional reviews of ED records to determine the extent 

to which alcohol and other substance abuse was involved in ED visits. According to the November 25, 2010, 

DAWN Report:

• In 2004, there were an estimated 115,803 ED visits involving pharmaceutical misuse and abuse by adults 

aged 50 or older; in 2008, there were 256,097 such visits, representing an increase of 121.1 percent 

• One fifth (19.7 percent) of ED visits involving pharmaceutical misuse and abuse among older adults were 

made by persons aged 70 or older 

• Among ED visits made by older adults, pain relievers were the type of pharmaceutical most commonly 

involved (43.5 percent), followed by drugs used to treat anxiety or insomnia (31.8 percent) and 

antidepressants (8.6 percent) 

• Among patients aged 50 or older who visited the ED for pharmaceutical misuse or abuse, more than half 

(52.3 percent) were treated and released, and more than one third (37.5 percent) were admitted to the 

hospital 

Bulleted text in italics above is taken from SAMHSA’s Center for Behavioral Health Statistics and Quality. (2010, November 25). The DAWN Report: Drugrelated emergency department visits involving pharmaceutical misuse and abuse by older adults. Rockville, MD: SAMHSA.

CO-OCCURRING SUBSTANCE USE AND MENTAL DISORDERS

Older Adults in Region 3 in SUD Treatment With Co-Occurring Mental Disorders

The national literature shows a strong 

relationship between substance use 

and mental disorders. Studies show 

that 30–80 percent of individuals with a 

substance use or mental disorder also 

have a co-occurring disorder.

TEDS data for West Virginia in 2012 

are unavailable. Therefore, Exhibit 11 

shows regional and national figures 

only.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Region 3 and the 

United States, 2012

43.6%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Region 3 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders
Alabama ALABAMA Profile 2015 West Virginia West Virginia Profile 2016

7

MENTAL HEALTH

Older West Virginians Reporting Frequent Mental Distress

BRFSS, a household survey conducted in 

all 50 states and several territories, asks 

the following question: “Now thinking 

about your mental health, which includes 

stress, depression, and problems with 

emotions, for how many days during the 

past 30 days was your mental health not 

good?” Those individuals reporting 14 

or more “Yes” days in response to this 

question experience frequent mental 

distress (FMD). Exhibit 12 shows that 

older West Virginians experience FMD 

at a rate that is higher than the regional 

and national rates. 

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in West Virginia, Region 3, and the United States, 2013

16.2%

18.2%

8.6%

12.7% 12.3%

7.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

18 to 49 50 to 64 65+

West Virginia Region 3 U.S.

Source: BRFSS, 2013

Older West Virginians Reporting Frequent Mental Distress by Age Group 

and Sex

Older men in West Virginia were more 

likely to indulge in binge drinking, but 

older women were more likely to report 

that they had FMD (14 days or more 

per 30-day period). As Exhibit 13 shows, 

20.3 percent of women in the 50–64 age 

group and 10.8 percent in the 65+ age 

group reported FMD, while 16.0 percent 

of men in the 50–64 age group and 

5.8 percent in the 65+ age group 

reported FMD.

Exhibit 13. West Virginians Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

13.7%

18.8%

16.0%

20.3%

5.8%

10.8%

0%

5%

10%

15%

20%

25%

Male Female

18 to 49 50 to 64 65+

Source: BRFSS, 2013

Proportion Reporting Frequent Mental Distress

Proportion Reporting Frequent Mental Distress
8

West Virginia West Virginia Profile 2016

Other Measures of Mental Health

BRFSS collected other measures showing risk factors for mental and/or physical illness. These included:

• Social and Emotional Support (2010). BRFSS asked, “How often do you get the social and emotional 

support you need?” The possible responses were always, usually, sometimes, rarely, or never. 

• Life Satisfaction (2010). BRFSS asked, “In general, how satisfied are you with your life?” The possible 

responses were very satisfied, satisfied, dissatisfied, or very dissatisfied.

Exhibit 14 presents the results of these surveys among older West Virginians.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 7.1% 8.1% 5.9%

Dissatisfied or very 

dissatisfied 6.6% 8.4% 4.4%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical health.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Source: BRFSS, 2013

Proportion Reporting Poor Physical Health
Alabama ALABAMA Profile 2015 West Virginia West Virginia Profile 2016

9

Relationship Among Mental Distress, Diabetes, Stroke, Heart Attack, 

High Blood Pressure, and Coronary Disease

Older Americans who experience FMD 

are more likely to report that they have 

health problems. People with FMD 

were more than twice as likely to report 

having a stroke than those with some 

or no mental distress. They experienced 

coronary disease and heart attack at 

more than 1.6 times, diabetes at more 

than 1.4 times, and high blood pressure 

at nearly 1.2 times the rate of those with 

some or no mental distress.

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

10.1%

13.3% 13.2%

25.9%

60.6%

4.7%

7.6% 7.8%

17.7%

51.1%

0%

10%

20%

30%

40%

50%

60%

70%

Stroke Coronary disease Heart attack Diabetes High blood pressure

Frequent mental distress Some or no mental distress

Source: BRFSS, 2013

Older West Virginians Admitted to State Mental Health Services

Approximately 3.8 percent of the people served by the West Virginia mental health system were ages 65 

and older. This represents more than 2,200 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014 Proportion Reporting Health Problems by Mental Health Category
10 West Virginia West Virginia Profile 2016

DATA SOURCES

BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (www.cdc.gov/brfss). BRFSS, managed by CDC, 

is the largest ongoing telephone health survey system in the world, tracking health conditions and risk 

behaviors in the United States annually since 1984. Data are collected on a monthly basis in all 50 states, 

the District of Columbia, and participating territories. BRFSS data are collected by local jurisdictions and 

reported to CDC.

CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL CENTER FOR HEALTH 

STATISTICS, UNDERLYING CAUSE OF DEATH 1999-2013 ON CDC WONDER ONLINE DATABASE, 

RELEASED 2015 (http://wonder.cdc.gov/ucd-icd10.html). The WONDER online database “contains 

mortality and population counts for all U.S. counties. Data are based on death certificates for U.S. 

residents. Each death certificate identifies a single underlying cause of death and demographic data. 

The number of deaths, crude death rates or age-adjusted death rates, and 95% confidence intervals 

and standard errors for death rates can be obtained by place of residence (total U.S., region, state and 

county), age group (single-year-of age, 5-year age groups, 10-year age groups and infant age groups), 

race, Hispanic ethnicity, gender, year, cause-of-death (4-digit ICD-10 code or group of codes), injury 

intent and injury mechanism, drug/alcohol induced causes and urbanization categories. Data are also 

available for place of death, month and week day of death, and whether an autopsy was performed.”

CENTER FOR MENTAL HEALTH SERVICES UNIFORM REPORTING SYSTEM (www.samhsa.gov/data

/us_map). States that receive CMHS Block Grants are required to report aggregate data to URS. URS 

reports include information about utilization of mental health services and client demographic and 

outcome information.

NATIONAL SURVEY ON DRUG USE AND HEALTH (https://nsduhweb.rti.org). The NSDUH, managed 

by SAMHSA, is “an annual nationwide survey involving interviews with approximately 70,000 randomly 

selected individuals aged 12 and older.” NSDUH data are most frequently used by state planners 

to assess the need for SUD treatment. NSDUH data also include information about mental health 

conditions.

TREATMENT EPISODE DATA SET (www.samhsa.gov/data/client-level-data-teds/reports?tab=19). States 

that receive Substance Abuse Prevention and Treatment Block Grant funds submit individual client data 

to TEDS. TEDS includes both admission and discharge data sets, and some 1.5 million admissions are 

reported annually. TEDS includes information about utilization of SUD treatment services and client 

demographic and outcome information. TEDS is an admission-based system, and TEDS admissions do 

not represent individuals. Thus, an individual admitted to treatment twice within a calendar year would 

be counted as two admissions.

U.S. CENSUS BUREAU (www.census.gov/people). Two main sources of Census Bureau data were used 

in this report: (1) population estimates and (2) population projections.