OLDER ADULTS BEHAVIORAL HEALTH PROFILES

REGION 1

CONNECTICUT 

MAINE 

MASSACHUSETTS 

NEW HAMPSHIRE 

RHODE ISLAND 

VERMONT

A Behavioral Health Resource

SAMHSA’s State Technical Assistance Contract 

February 2016
OLDER ADULTS BEHAVIORAL HEALTH PROFILES

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.

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

Task Order. Reference #HHSS283201200002I/Task Order No. HHSS28342002T.
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

Connecticut
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

February 2016

CONNECTICUT’S POPULATION

Connecticut Population by Age Group

Connecticut is home to 3,596,677 people. 

Of these:

• 1,328,275 (36.9 percent) are over age 50.

• 774,577 (21.5 percent) are over age 60.

• 378,820 (10.5 percent) are over age 70.

• 161,457 (4.5 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 63.7 percent of the 80+ group. 

The racial/ethnic composition of older 

Connecticuters is as follows:

Race/Ethnicity of Connecticuters Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

88.1% 0.3% 8.1% 2.7% 0.1% 0.8% 7.2%

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. Connecticut Population by Age Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older Connecticuters Is Growing

The proportion of Connecticut’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 

21.5 percent of Connecticut’s population 

will be 65 and older by the year 2030, 

an increase of 37.7 percent from 2015.

Projected Population in Connecticut

Age Group 2015 2025 2030

Under 18 22.2% 22.4% 22.3%

18 to 44 34.4% 33.8% 33.0%

45 to 64 27.5% 24.2% 23.1%

65+ 15.9% 19.6% 21.5%

Source: U.S. Census Bureau, 2005

Connecticut

Exhibit 2. Connecticut Population by Age Group, 

2000–2030

Population in 1,000s

Population in 1,000s

0

200

400

600

800

1,000

1,200

1,400

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+
2

Connecticut Connecticut Profile 2016

SUICIDE AMONG OLDER CONNECTICUTERS

Connecticut Suicide Rate Compared With Regional and National Rates 

The suicide rate among Connecticuters 

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 12.1 per 100,000 people (4.7 

for women and 20.7 for men). The rate 

among those ages 50–64 was lower than 

both the rate in the region (including 

Maine, Massachusetts, New Hampshire, 

Rhode Island, and Vermont) 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 Connecticut, Region 1, and the 

United States, 2013

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 Connecticut

The suicide rate among 

Connecticuters ages 50+ fluctuated 

from a low of 9.9 per 100,000 in 2004 

to a high of 12.6 per 100,000 in 2010. 

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 Connecticut by Age 

Group, 2004–2013

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 Connecticut Connecticut Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER CONNECTICUTERS

30-Day Binge Drinking Among Older Connecticuters

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, 17.4 percent 

of Connecticut men ages 50–64 reported 

binge drinking in the past 30 days, while 

5.3 percent of those in the 65+ group 

reported similar behavior. 

Exhibit 5. Binge Drinking Rates in Connecticut by Age 

Group and Sex, 2013

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 Connecticut 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

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

Connecticut Connecticut Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Connecticuters

In 2012, there were 9,693 admissions 

of Connecticuters ages 50 and older to 

substance use disorder (SUD) treatment in 

state-funded treatment programs, a rate 

of 729.7 per 100,000 people ages 50+. 

This rate was higher than the regional 

rate and the national average. Men made 

up 73.8 percent of these admissions. Of 

all admissions, 65.1 percent were White/

Caucasian, 20.5 percent were Black/African 

American, and 13.7 percent were Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

48.6% 21.4% 30.0%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ in 

Connecticut, Region 1, and the United States by Sex, 2012

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 1 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 

Connecticut in 2012. Therefore, the rates 

for Region 1 are used instead.

In Region 1, 15.9 percent of older adult 

admissions to SUD treatment were 

uninsured, 54.4 percent had Medicaid, 

11.6 percent had Medicare, and 

18.1 percent had private insurance.

SUD Treatment Admissions Among 

Connecticuters 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 1 and the United States by Insurance Type, 2012

18.1%

54.4%

11.6%

15.9% 14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

Private Medicaid Medicare None

Region 1 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 Connecticut Connecticut Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Connecticuters Ages 50+

Alcohol was the most frequently 

cited substance used by older 

Connecticuters in publicly financed 

SUD treatment in 2012. It was 

mentioned as a substance of use in 

62.5 percent of admissions among 

those ages 50+. This was lower than 

the regional rate and higher than the 

national rate.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Connecticut, Region 1, and the United States, 

2012

62.5%

67.7%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Connecticut Region 1 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 37.5 percent of older adult 

admissions to publicly funded 

treatment in Connecticut.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Connecticut, Region 1, 

and the United States, 2012

37.5%

32.3%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Connecticut Region 1 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

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

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder
6

Connecticut Connecticut 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 1 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 Connecticut 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 1 and the 

United States, 2012

46.7%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Region 1 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder
Alabama ALABAMA Profile 2015 Connecticut Connecticut Profile 2016

7

MENTAL HEALTH

Older Connecticuters 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 Connecticuters experience FMD 

at a rate that is higher than the regional 

rate and lower than the national rate.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Connecticut, Region 1, and the United States, 2013

10.9%

12.4%

6.5%

12.8%

11.7%

6.4%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

Connecticut Region 1 U.S.

Source: BRFSS, 2013

Older Connecticuters Reporting Frequent Mental Distress by Age Group and Sex

Older men in Connecticut 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, 

14.1 percent of women in the 50–64 age 

group and 7.8 percent in the 65+ age 

group reported FMD, while 10.6 percent 

of men in the 50–64 age group and 

4.8 percent in the 65+ age group 

reported FMD.

Exhibit 13. Connecticuters Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

8.7%

13.2%

10.6%

14.1%

4.8%

7.8%

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

Connecticut Connecticut 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 Connecticuters.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+ 

Rarely or never get social 

or emotional support 9.4% 7.7% 11.9%

Dissatisfied or very 

dissatisfied 4.5% 5.2% 3.7%

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 Connecticut Connecticut 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 Connecticuters Admitted to State Mental Health Services

Approximately 4.4 percent of the people served by the Connecticut mental health system were ages 65 and 

older. This represents more than 4,085 adults.

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

Maine
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

February 2016

MAINE’S POPULATION

Maine Population by Age Group

Maine is home to 1,330,089 people. 

Of these:

• 557,974 (42.0 percent) are over age 50.

• 341,707 (25.7 percent) are over age 60.

• 161,151 (12.1 percent) are over age 70.

• 62,295 (4.7 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 61.9 percent of the 80+ group. 

The racial/ethnic composition of older 

Mainers is as follows:

Race/Ethnicity of Mainers Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

97.6% 0.5% 0.5% 0.7% 0.0% 0.7% 0.6%

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. Maine Population by Age Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older Mainers Is Growing

The proportion of Maine’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 26.5 percent of Maine’s 

population will be 65 and older by the 

year 2030, an increase of 49.5 percent 

from 2015.

Projected Population in Maine

Age Group 2015 2025 2030

Under 18 19.3% 18.7% 18.1%

18 to 44 32.8% 30.9% 29.0%

45 to 64 29.9% 26.4% 26.4%

65+ 18.0% 24.0% 26.5%

Source: U.S. Census Bureau, 2005

Maine

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

Population in 1,000s
2

Maine Maine Profile 2016

SUICIDE AMONG OLDER MAINERS

Maine Suicide Rate Compared With Regional and National Rates 

The suicide rate among Mainers 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 21.9 per 100,000 people (8.3 

for women and 37.2 for men). The rate 

among those ages 50–64 was higher than 

both the rate in the region (including 

Connecticut, Massachusetts, New 

Hampshire, Rhode Island, and Vermont) 

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 Maine, Region 1, and the 

United States, 2013

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 Maine

The suicide rate among Mainers ages 

50+ fluctuated from a low of 15.1 per 

100,000 in 2004 to a high of 21.9 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 Maine by Age Group, 

2004–2013

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 Maine Maine Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER MAINERS

30-Day Binge Drinking Among Older Mainers

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 Maine men ages 50–64 reported binge 

drinking in the past 30 days, while 

5.6 percent of those in the 65+ group 

reported similar behavior. 

Exhibit 5. Binge Drinking Rates in Maine by Age Group 

and Sex, 2013

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 

Maine 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

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

Maine Maine Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Mainers

In 2012, there were 1,731 admissions of 

Mainers ages 50 and older to substance 

use disorder (SUD) treatment in statefunded treatment programs, a rate of 

310.2 per 100,000 people ages 50+. 

This rate was lower than the regional 

rate and higher than the national 

average. Men made up 68.8 percent 

of these admissions. Of all admissions, 

95.3 percent were White/Caucasian, 2.0 

percent were Black/African American, 

and 1.3 percent were Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Source: Treatment Episode Data Set (TEDS), 2012

Self-Referral Criminal Justice Other

47.7% 18.8% 33.4%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Maine, Region 1, and the United States by Sex, 2012

1

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 Mainers Ages 50+ by Insurance Type 

In Maine, 21.0 percent of older adult 

admissions to SUD treatment were 

uninsured, 46.1 percent had Medicaid, 

15.9 percent had Medicare, and 

17.0 percent had private insurance.

SUD Treatment Admissions Among 

Mainers Ages 50+ by Primary Sources of 

Payment

Self-Pay Medicaid Other

16.6% 19.5% 63.9%

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 Maine, Region 1, 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 Maine Maine Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Mainers Ages 50+

Alcohol was the most frequently cited 

substance used by older Mainers in 

publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 79.8 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 Maine, Region 1, and the United States, 2012

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 20.2 percent of older adult 

admissions to publicly funded 

treatment in Maine.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Maine, Region 1, 

and the United States, 2012

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

Maine Maine 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 Mainers 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 Mainers 

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 Maine, Region 1, 

and the United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder
Alabama ALABAMA Profile 2015 Maine Maine Profile 2016

7

MENTAL HEALTH

Older Mainers 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 

Mainers experience FMD at a rate that 

is lower than the regional and national 

rates. 

Exhibit 12. Individuals Reporting Frequent Mental 

Distress in Maine, Region 1, and the United States, 2013

Source: BRFSS, 2013

Older Mainers Reporting Frequent Mental Distress by Age Group and Sex

Older men in Maine 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 6.3 percent in the 

65+ age group reported FMD, while 

9.8 percent of men in the 50–64 age 

group and 5.7 percent in the 65+ age 

group reported FMD.

Exhibit 13. Mainers Reporting Frequent Mental Distress 

by Age Group and Sex, 2013

Source: BRFSS, 2013

Proportion Reporting Frequent Mental Distress

Proportion Reporting Frequent Mental Distress
8

Maine Maine 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 Mainers.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+ 

Rarely or never get social 

or emotional support 8.6% 6.9% 11.0%

Dissatisfied or very 

dissatisfied 4.3% 5.3% 2.8%

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

Source: BRFSS, 2013

Proportion Reporting Poor Physical Health
Alabama ALABAMA Profile 2015 Maine Maine 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

Source: BRFSS, 2013

Older Mainers Admitted to State Mental Health Services

Approximately 4.3 percent of the people served by the Maine mental health system were ages 65 and older. 

This represents more than 2,928 adults.

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

Massachusetts
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

February 2016

MASSACHUSETTS’ POPULATION

Massachusetts Population by Age Group

Massachusetts is home to 6,745,408 people. 

Of these:

• 2,412,933 (35.8 percent) are over age 50.

• 1,421,787 (21.1 percent) are over age 60.

• 685,300 (10.2 percent) are over age 70.

• 287,837 (4.3 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 64.2 percent of the 80+ group. 

The racial/ethnic composition of older 

Massachusettsans is as follows:

Race/Ethnicity of Massachusettsans Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

89.1% 0.3% 5.7% 4.0% 0.1% 0.8% 5.1%

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. Massachusetts Population by Age 

Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older Massachusettsans Is Growing

The proportion of Massachusetts’ 

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 

20.9 percent of Massachusetts’ 

population will be 65 and older 

by the year 2030, an increase of 

42.7 percent from 2015.

Projected Population in Massachusetts

Age Group 2015 2025 2030

Under 18 21.8% 21.9% 22.0%

18 to 44 35.5% 34.6% 34.1%

45 to 64 27.5% 24.5% 22.9%

65+ 15.2% 19.0% 20.9%

Source: U.S. Census Bureau, 2005

Exhibit 2. Massachusetts Population by Age Group, 

2000–2030

MassachusettsPopulation in 1,000s Population in 1,000s
2

Massachusetts Massachusetts Profile 2016

SUICIDE AMONG OLDER MASSACHUSETTSANS

Massachusetts Suicide Rate Compared With Regional and National Rates 

The suicide rate among 

Massachusettsans 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 9.8 

per 100,000 people (4.9 for women and 

15.7 for men). The rate among those 

ages 50–64 was lower than both the rate 

in the region (including Connecticut, 

Maine, New Hampshire, Rhode Island, 

and Vermont) 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 Massachusetts, Region 1, and 

the United States, 2013

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 Massachusetts

The suicide rate among 

Massachusettsans ages 50+ fluctuated 

from a low of 8.0 per 100,000 in 2004 

to a high of 10.8 per 100,000 in 2010. 

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 Massachusetts by 

Age Group, 2004–2013

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 Massachusetts Massachusetts Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER MASSACHUSETTSANS

30-Day Binge Drinking Among Older Massachusettsans

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. Binge 

drinking decreases with age and occurs 

more frequently among men than it does 

among women. Older people have a lower 

tolerance for alcohol. As Exhibit 5 shows, 

19.1 percent of Massachusetts men ages 

50–64 reported binge drinking in the past 

30 days, while 5.9 percent of those in the 

65+ group reported similar behavior. 

Exhibit 5. Binge Drinking Rates in Massachusetts by 

Age Group and Sex, 2013

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 Massachusetts 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

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

Massachusetts Massachusetts Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Massachusettsans

In 2012, there were 10,883 admissions 

of Massachusettsans ages 50 and 

older to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 451.0 per 100,000 

people ages 50+. This rate was lower 

than the regional rate and higher than 

the national average. Men made up 

73.8 percent of these admissions. Of all 

admissions, 78.7 percent were White/

Caucasian, 11.8 percent were Black/

African American, and 7.9 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

51.5% 22.8% 25.7

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ in 

Massachusetts, Region 1, and the United States by Sex, 2012

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 Massachusettsans Ages 50+ by 

Insurance Type

In Massachusetts, 13.7 percent of older 

adult admissions to SUD treatment 

were uninsured, 57.7 percent had 

Medicaid, 10.7 percent had Medicare, 

and 18.0 percent had private insurance.

SUD Treatment Admissions Among 

Massachusettsans 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 Massachusetts, Region 1, 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 Massachusetts Massachusetts Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Massachusettsans 

Ages 50+

Alcohol was the most frequently 

cited substance used by older 

Massachusettsans in publicly financed 

SUD treatment in 2012. It was 

mentioned as a substance of use in 

68.5 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 Massachusetts, Region 1, and the United 

States, 2012

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 31.5 percent of older adult 

admissions to publicly funded 

treatment in Massachusetts.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Massachusetts, 

Region 1, and the United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

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

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder
6

Massachusetts Massachusetts 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 Massachusettsans 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 

Massachusettsans ages 50+ with a 

co-occurring mental disorder. This 

rate is lower than the regional rate 

and higher than 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 Massachusetts, 

Region 1, and the United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder
Alabama ALABAMA Profile 2015 Massachusetts Massachusetts Profile 2016

7

MENTAL HEALTH

Older Massachusettsans 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 

Massachusettsans experience FMD at 

a rate that is roughly similar to the 

regional rate and lower than the 

national rate.

Exhibit 12. Individuals Reporting Frequent Mental 

Distress in Massachusetts, Region 1, and the United 

States, 2013

Source: BRFSS, 2013

Older Massachusettsans Reporting Frequent Mental Distress by Age Group 

and Sex

Older men in Massachusetts 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, 

12.3 percent of women in the 50–64 age 

group and 7.2 percent in the 65+ age 

group reported FMD, while 10.5 percent 

of men in the 50–64 age group and 

6.4 percent in the 65+ age group 

reported FMD.

Exhibit 13. Massachusettsans Reporting Frequent 

Mental Distress by Age Group and Sex, 2013

Source: BRFSS, 2013

Proportion Reporting Frequent Mental Distress

Proportion Reporting Frequent Mental Distress
8

Massachusetts Massachusetts 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 Massachusettsans.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+ 

Rarely or never get social 

or emotional support 8.1% 6.2% 11.0%

Dissatisfied or very 

dissatisfied with life 4.6% 5.3% 3.7%

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

Source: BRFSS, 2013

Proportion Reporting Poor Physical Health
Alabama ALABAMA Profile 2015 Massachusetts Massachusetts 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

Source: BRFSS, 2013

Older Massachusettsans Admitted to State Mental Health Services

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

and older. This represents more than 1,506 adults.

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

New Hampshire
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

February 2016

NEW HAMPSHIRE’S POPULATION

New Hampshire Population by Age Group

New Hampshire is home to 1,326,813 people. 

Of these:

• 520,980 (39.3 percent) are over age 50.

• 301,008 (22.7 percent) are over age 60.

• 137,340 (10.4 percent) are over age 70.

• 53,353 (4.0 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 62.2 percent of the 80+ group. 

The racial/ethnic composition of older 

New Hampshirites is as follows:

Race/Ethnicity of New Hampshirites Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

97.0% 0.2% 0.8% 1.3% 0.0% 0.7% 1.3%

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. New Hampshire Population by Age 

Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older New Hampshirites Is Growing

The proportion of New Hampshire’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 

21.4 percent of New Hampshire’s 

population will be 65 and older by the 

year 2030, an increase of 62.2 percent 

from 2015.

Projected Population in New Hampshire

Age Group 2015 2025 2030

Under 18 21.5% 21.7% 21.6%

18 to 44 34.8% 33.9% 32.7%

45 to 64 28.7% 24.8% 24.3%

65+ 14.9% 19.6% 21.4%

Source: U.S. Census Bureau, 2005

Exhibit 2. New Hampshire Population by Age Group, 

2000–2030

New Hampshire Population in 1,000s Population in 1,000s
2

New Hampshire New Hampshire Profile 2016

SUICIDE AMONG OLDER NEW HAMPSHIRITES

New Hampshire Suicide Rate Compared With Regional and National Rates 

The suicide rate among New 

Hampshirites 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 17.7 per 

100,000 people (7.9 for women and 28.4 

for men). The rate among those ages 

50–64 was higher than both the rate 

in the region (including Connecticut, 

Maine, Massachusetts, Rhode Island, 

and Vermont) 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 New Hampshire, Region 1, 

and the United States, 2013

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 New Hampshire

The suicide rate among New 

Hampshirites ages 50+ fluctuated 

from a low of 12.8 per 100,000 in 

2004 to a high of 19.8 per 100,000 

in 2010. 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 New Hampshire by 

Age Group, 2004–2013

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 New Hampshire New Hampshire Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER NEW HAMPSHIRITES

30-Day Binge Drinking Among Older New Hampshirites

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, 

17.1 percent of New Hampshire men ages 

50–64 reported binge drinking in the past 

30 days, while 7.0 percent of those in the 

65+ group reported similar behavior. 

Exhibit 5. Binge Drinking Rates in New Hampshire by 

Age Group and Sex, 2013

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 New Hampshire 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

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

New Hampshire New Hampshire Profile 2016

Admissions to Substance Use Disorder Treatment Among Older 

New Hampshirites

In 2012, there were 482 admissions of 

New Hampshirites ages 50 and older to 

substance use disorder (SUD) treatment 

in state-funded treatment programs, a 

rate of 92.5 per 100,000 people ages 

50+. This rate was lower than the 

regional rate and the national average. 

Men made up 62.0 percent of these 

admissions. Of all admissions, 

96.1 percent were White/Caucasian, 

1.2 percent were Black/African 

American, and 1.5 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

42.6% 28.9% 28.5%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ in 

New Hampshire, Region 1, and the United States by Sex, 2012

120.3

731.2

383.2

67.2

237.1

120.3

0

100

200

300

400

500

600

700

800

New Hampshire Region 1 U.S.

SUD Admission Rate per 100,000 Population

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 New Hampshirites Ages 50+ by 

Insurance Type 

In New Hampshire, 47.9 percent 

of older adult admissions to SUD 

treatment were uninsured, 9.6 percent 

had Medicaid, 18.2 percent had 

Medicare, and 24.4 percent had private 

insurance.

SUD Treatment Admissions Among 

New Hampshirites Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

67.5% 3.6% 28.8%

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 New Hampshire, Region 1, and the United States by 

Insurance Type, 2012

24.4%

9.6%

18.2%

47.9%

18.1%

54.4%

11.6%

15.9% 14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

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

Private Medicaid Medicare None

New Hampshire Region 1 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
Alabama ALABAMA Profile 2015 New Hampshire New Hampshire Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among New Hampshirites 

Ages 50+

Alcohol was the most frequently 

cited substance used by older New 

Hampshirites in publicly financed SUD 

treatment in 2012. It was mentioned 

as a substance of use in 85.7 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 New Hampshire, Region 1, and the United 

States, 2012

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 14.3 percent of older adult 

admissions to publicly funded 

treatment in New Hampshire.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in New Hampshire, 

Region 1, and the United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

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

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder
6

New Hampshire New Hampshire 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 New Hampshirites 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 New 

Hampshirites 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 New Hampshire, 

Region 1, and the United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder
Alabama ALABAMA Profile 2015 New Hampshire New Hampshire Profile 2016

7

MENTAL HEALTH

Older New Hampshirites 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 

New Hampshirites experience FMD at a 

rate that is lower than the regional and 

national rates.

Exhibit 12. Individuals Reporting Frequent Mental 

Distress in New Hampshire, Region 1, and the United 

States, 2013

Source: BRFSS, 2013

Older New Hampshirites Reporting Frequent Mental Distress by Age Group 

and Sex

Older men in New Hampshire 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, 

12.3 percent of women in the 50–64 age 

group and 5.5 percent in the 65+ age 

group reported FMD, while 9.2 percent 

of men in the 50–64 age group and 

4.2 percent in the 65+ age group 

reported FMD.

Exhibit 13. New Hampshirites Reporting Frequent 

Mental Distress by Age Group and Sex, 2013

Source: BRFSS, 2013

Proportion Reporting Frequent Mental Distress

Proportion Reporting Frequent Mental Distress
8

New Hampshire New Hampshire 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 New Hampshirites.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+ 

Rarely or never get social 

or emotional support 9.3% 6.8% 13.3%

Dissatisfied or very 

dissatisfied with life 4.7% 5.8% 2.9%

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

Source: BRFSS, 2013

Proportion Reporting Poor Physical Health
Alabama ALABAMA Profile 2015 New Hampshire New Hampshire 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

Source: BRFSS, 2013

Older New Hampshirites Admitted to State Mental Health Services

Approximately 6.3 percent of the people served by the New Hampshire mental health system were ages 65 

and older. This represents more than 2,945 adults.

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

Rhode Island
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

February 2016

RHODE ISLAND’S POPULATION

Rhode Island Population by Age Group

Rhode Island is home to 1,055,173 people. 

Of these:

• 388,076 (36.8 percent) are over age 50.

• 231,097 (21.9 percent) are over age 60.

• 113,514 (10.8 percent) are over age 70.

• 49,893 (4.7 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 65.1 percent of the 80+ group. 

The racial/ethnic composition of older 

Rhode Islanders is as follows:

Race/Ethnicity of Rhode Islanders Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

91.8% 0.6% 4.7% 2.0% 0.1% 0.9% 6.3%

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. Rhode Island Population by Age Group, 

2014

Source: U.S. Census Bureau, 2015

The Number of Older Rhode Islanders Is Growing

The proportion of Rhode Island’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 

21.4 percent of Rhode Island’s population will be 65 and older by the year 

2030, an increase of 40.7 percent from 

2015.

Projected Population in Rhode Island

Age Group 2015 2025 2030

Under 18 21.8% 22.2% 21.9%

18 to 44 36.1% 34.4% 33.6%

45 to 64 26.7% 24.1% 23.1%

65+ 15.4% 19.4% 21.4%

Source: U.S. Census Bureau, 2005

Exhibit 2. Rhode Island Population by Age Group, 

2000–2030

Rhode Island

Population in 1,000s

Population in 1,000s
2

Rhode Island Rhode Island Profile 2016

SUICIDE AMONG OLDER RHODE ISLANDERS

Rhode Island Suicide Rate Compared With Regional and National Rates 

The suicide rate among Rhode Islanders 

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 15.7 per 100,000 people 

(unreliable data for women and 26.4 

for men). The rate among those ages 

50–64 was higher than the rate in the 

region (including Connecticut, Maine, 

Massachusetts, New Hampshire, and 

Vermont) and 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 Rhode Island, Region 1, and 

the United States, 2013

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 1

Suicide data for Rhode Islanders 

of various ages were unavailable. 

Therefore, the rates for Region 1 are 

used instead.

The suicide rate among individuals in 

Region 1 ages 50+ fluctuated from a 

low of 10.4 per 100,000 in 2004 to a 

high of 13.9 per 100,000 in 2011. 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 Region 1 by Age Group, 

2004–2013

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 Rhode Island Rhode Island Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER RHODE ISLANDERS

30-Day Binge Drinking Among Older Rhode Islanders

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, 

17.9 percent of Rhode Island men ages 

50–64 reported binge drinking in the past 

30 days, while 6.0 percent of those in the 

65+ group reported similar behavior.

Exhibit 5. Binge Drinking Rates in Rhode Island by Age 

Group and Sex, 2013

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 Rhode Island 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

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

Rhode Island Rhode Island Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Rhode Islanders

In 2012, there were 1,626 admissions 

of Rhode Islanders ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 419.0 per 100,000 

people ages 50+. This rate was lower 

than the regional rate and higher than 

the national average. Men made up 

69.6 percent of these admissions. Of all 

admissions, 87.8 percent were White/

Caucasian, 10.2 percent were Black/

African American, and 6.3 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

47.0% 19.5% 33.5

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ in 

Rhode Island, Region 1, and the United States by Sex, 2012

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 1 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 Rhode Island in 2012. 

Therefore, the rates for Region 1 are 

used instead.

In Region 1, 15.9 percent of older adult 

admissions to SUD treatment were 

uninsured, 54.4 percent had Medicaid, 

11.6 percent had Medicare, and 

18.1 percent had private insurance.

SUD Treatment Admissions Among 

Rhode Islanders Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

35.7% 20.7% 43.7%

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 Region 1 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 Rhode Island Rhode Island Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Rhode Islanders Ages 50+

Alcohol was the most frequently 

cited substance used by older Rhode 

Islanders in publicly financed SUD 

treatment in 2012. It was mentioned 

as a substance of use in 67.7 percent 

of admissions among those ages 50+. 

This was equal to the regional rate and 

higher than the national rate.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Rhode Island, Region 1, and the United 

States, 2012

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 32.3 percent of older adult 

admissions to publicly funded 

treatment in Rhode Island.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Rhode Island, Region 1, 

and the United States, 2012

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

Rhode Island Rhode Island 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 Rhode Islanders 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 Rhode 

Islanders 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 Rhode Island, 

Region 1, and the United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder
Alabama ALABAMA Profile 2015 Rhode Island Rhode Island Profile 2016

7

MENTAL HEALTH

Older Rhode Islanders 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 

Rhode Islanders in the 50–64 age group 

experience FMD at a rate higher than the 

regional rate and equal to the national 

rate while those in the 65+ age group 

experience it at a rate lower than the 

regional and national rates. 

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Rhode Island, Region 1, and the United States, 2013

Source: BRFSS, 2013

Older Rhode Islanders Reporting Frequent Mental Distress by Age Group and 

Sex

Older men in Rhode Island 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, 

13.5 percent of women in the 50–64 age 

group and 6.9 percent in the 65+ age 

group reported FMD, while 12.5 percent 

of men in the 50–64 age group and 

5.0 percent in the 65+ age group 

reported FMD.

Exhibit 13. Rhode Islanders Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Source: BRFSS, 2013

Proportion Reporting Frequent Mental Distress

Proportion Reporting Frequent Mental Distress
8

Rhode Island Rhode Island 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 Rhode Islanders.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+ 

Rarely or never get social 

or emotional support 11.0% 7.9% 15.2%

Dissatisfied or very 

dissatisfied with life 5.0% 5.7% 4.1%

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

Proportion Reporting Poor Physical Health

0%

50%

60%

No mental distress Some mental distress Frequent mental distress

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 Rhode Island Rhode Island 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

Source: BRFSS, 2013

Older Rhode Islanders Admitted to State Mental Health Services

Approximately 4.5 percent of the people served by the Rhode Island mental health system were ages 65 

and older. This represents more than 1,444 adults.

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

Vermont
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

February 2016

VERMONT’S POPULATION

Vermont Population by Age Group

Vermont is home to 626,562 people. 

Of these:

• 252,058 (40.2 percent) are over age 50.

• 151,671 (24.2 percent) are over age 60.

• 69,371 (11.1 percent) are over age 70.

• 26,834 (4.3 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 62.3 percent of the 80+ group. 

The racial/ethnic composition of older 

Vermonters is as follows:

Race/Ethnicity of Vermonters Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

97.5% 0.3% 0.5% 0.8% 0.0% 0.9% 0.8%

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. Vermont Population by Age Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older Vermonters Is Growing

The proportion of Vermont’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 24.4 percent of Vermont’s 

population will be 65 and older by the 

year 2030, an increase of 53.3 percent 

from 2015.

Projected Population in Vermont

Age Group 2015 2025 2030

Under 18 19.6% 19.8% 19.5%

18 to 44 34.9% 33.3% 32.0%

45 to 64 28.7% 24.4% 24.1%

65+ 16.9% 22.5% 24.4%

Source: U.S. Census Bureau, 2005

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

Vermont

Population in 1,000s

Population in 1,000s
2

Vermont Vermont Profile 2016

SUICIDE AMONG OLDER VERMONTERS

Vermont Suicide Rate Compared With Regional and National Rates 

The suicide rate among Vermonters 

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 20.9 per 100,000 people 

(unreliable data for women and 35.6 for 

men). The rate among those ages 50–64 

was higher than both the rate in the 

region (including Connecticut, Maine, 

Massachusetts, New Hampshire, and 

Rhode Island) 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 Vermont, Region 1, and the 

United States, 2013

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 Vermont

The suicide rate among Vermonters 

ages 50+ fluctuated from a low of 

11.2 per 100,000 in 2005 to a high 

of 23.3 per 100,000 in 2011. From 

2004 to 2013, the rate was generally 

highest among those in the 65+ 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 Vermont by Age Group, 

2004–2013

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 Vermont Vermont Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER VERMONTERS

30-Day Binge Drinking Among Older Vermonters

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, 

15.3 percent of Vermont men ages 50–64 

reported binge drinking in the past 30 

days, while 5.7 percent of those in the 65+ 

group reported similar behavior.

Exhibit 5. Binge Drinking Rates in Vermont by Age 

Group and Sex, 2013

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 Vermont 

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

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

Vermont Vermont Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Vermonters

In 2012, there were 1,030 admissions 

of Vermonters ages 50 and older to 

substance use disorder (SUD) treatment 

in state-funded treatment programs, a 

rate of 408.6 per 100,000 people ages 

50+. This rate was lower than the regional rate and higher than the national average. Men made up 67.8 percent 

of these admissions. Of all admissions, 

96.7 percent were White/Caucasian, 

1.9 percent were Black/African 

American, and 1.3 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

38.9% 23.8% 37.3%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Vermont, Region 1, and the United States by Sex, 2012

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 1 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 

Vermont in 2012. Therefore, the rates for 

Region 1 are used instead. 

In Region 1, 15.9 percent of older adult 

admissions to SUD treatment were 

uninsured, 54.4 percent had Medicaid, 

11.6 percent had Medicare, and 

18.1 percent had private insurance.

SUD Treatment Admissions Among 

Vermonters Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

27.0% 56.7% 16.3%

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 Region 1 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 Vermont Vermont Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Vermonters Ages 50+

Alcohol was the most frequently cited 

substance used by older Vermonters 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 79.4 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 Vermont, Region 1, and the United States, 

2012

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 20.6 percent of older 

adult admissions to publicly funded 

treatment in Vermont.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Vermont, Region 1, 

and the United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

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

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder
6

Vermont Vermont 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 1 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 Vermont 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 1 and the 

United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder
Alabama ALABAMA Profile 2015 Vermont Vermont Profile 2016

7

MENTAL HEALTH

Older Vermonters 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 

Vermonters experience FMD at a rate 

that is lower than the regional and 

national rates. 

Exhibit 12. Individuals Reporting Frequent Mental 

Distress in Vermont, Region 1, and the United States, 

2013

Source: BRFSS, 2013

Older Vermonters Reporting Frequent Mental Distress by Age Group and Sex

In Vermont, men in the 50–64 age group 

reported FMD at nearly the same rate 

as women (14 days or more per 30-day 

period), in contrast to other states in 

the region, where women in the same 

age group reported higher rates of FMD. 

As Exhibit 13 shows, 10.9 percent of 

men in the 50–64 age group reported 

FMD compared with 10.8 percent of 

women in the 50–64 age group. In the 

65+ age group, 5.0 percent of men 

reported FMD compared with 

5.6 percent of women.

Exhibit 13. Vermonters Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Source: BRFSS, 2013

Proportion Reporting Frequent Mental Distress

Proportion Reporting Frequent Mental Distress
8

Vermont Vermont 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 Vermonters.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+ 

Rarely or never get social 

or emotional support 7.4% 5.2% 10.7%

Dissatisfied or very 

dissatisfied with life 4.1% 4.8% 3.0%

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

Source: BRFSS, 2013

Proportion Reporting Poor Physical Health
Alabama ALABAMA Profile 2015 Vermont Vermont 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

Source: BRFSS, 2013

Older Vermonters Admitted to State Mental Health Services

Approximately 5.8 percent of the people served by the Vermont mental health system were ages 65 and 

older. This represents more than 1,421 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014 Proportion Reporting Health Problems by Mental Health Category
10 Vermont Vermont 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 (http://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.