OLDER ADULTS BEHAVIORAL HEALTH PROFILES

REGION 4

MS AL GA

NC

SC

FL

KY

ALABAMA TN

FLORIDA 

GEORGIA 

KENTUCKY 

MISSISSIPPI 

NORTH CAROLINA

SOUTH CAROLINA

TENNESSEE

A Behavioral Health Resource

SAMHSA’s State Technical Assistance Contract 

August 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

Alabama
 
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

ALABAMA’S POPULATION

Alabama Population by Age Group

Alabama is home to 4,849,377 people. 

Of these:

• 1,718,155 (35.4 percent) are over age 50.

• 1,038,121 (21.4 percent) are over age 60.

• 492,943 (10.2 percent) are over age 70.

• 174,846 (3.6 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 63.9 percent of the 80+ group. 

The racial/ethnic composition of older 

Alabamians is as follows:

Race/Ethnicity of Alabamians 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

75.7% 0.6% 22.0% 0.9% 0.0% 0.8% 1.4%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

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

Exhibit 1. Alabama Population by Age Group, 2014

307 322 334

295 304 328

256

141

63

295 311

336

309 320

352

289

177

112

0

100

200

300

400

500

600

700

800

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

Population in 1,000s

Male Female

Source: U.S. Census Bureau, 2015

The Number of Older Alabamians Is Growing

The proportion of Alabama’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 21.3 percent of 

Alabama’s population will be 65 and 

older by the year 2030, an increase of 

40.5 percent from 2015.

Projected Population in Alabama

Age Group 2015 2025 2030

Under 18 23.4% 22.8% 22.8%

18 to 44 33.8% 32.2% 31.8%

45 to 64 27.0% 25.1% 24.0%

65+ 15.9% 19.9% 21.3%

Source: U.S. Census Bureau, 2005

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

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

Population in 1,000s Population in 1,000s

August 2016

Alabama
2

Alabama Alabama Profile 2016

SUICIDE AMONG OLDER ALABAMIANS

Alabama Suicide Rate Compared With Regional and National Rates

The suicide rate among Alabamians 

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 20.5 per 100,000 people (7.7 

for women and 35.6 for men). The rate 

among those ages 50–64 was higher than 

both the rate in the region (including 

Florida, Georgia, Kentucky, Mississippi, 

North Carolina, South Carolina, and 

Tennessee) and the rate in the United 

States. 

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

14.9

11.9

21.5

19.1

14.2

11.4

20.8

18.1

13.0

10.6

19.0

16.1

0

5

10

15

20

25

All Under 50 50 to 64 65+

Alabama Region 4 U.S.

Exhibit 3. Suicide Rates in Alabama, Region 4, and the 

United States, 2013

Suicide Rate per 100,000 Population

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 Alabama

The suicide rate among Alabamians 

ages 50+ fluctuated from a low of 

15.7 per 100,000 in 2006 and 2008 

to a high of 20.5 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.

0

5

10

15

20

25

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

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

2004–2013

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 Alabama Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER ALABAMIANS

30-Day Binge Drinking Among Older Alabamians

Binge drinking, defined as five or more 

drinks for men and four or more drinks 

for women on a single occasion, can 

lead to serious health problems. Such 

problems include neurological damage, 

cardiovascular disease, liver disease, 

stroke, and poor control of diabetes. 

Binge drinkers are more likely to take risks 

such as driving while intoxicated and to 

experience falls and other accidents. Older 

people have a lower tolerance for alcohol. 

Binge drinking decreases with age and 

occurs more frequently among men than 

it does among women. As Exhibit 5 shows, 

14.8 percent of Alabama men ages 50–64 

reported binge drinking in the past 

30 days, while 2.9 percent of those in the 

65+ group reported similar behavior. 

21.3%

14.8%

2.9%

9.6%

4.4%

1.5% 0%

5%

10%

15%

20%

25%

18 to 49 50 to 64 65+

Male Female

Exhibit 5. Binge Drinking Rates in Alabama by Age 

Group and Sex, 2013

Proportion of Population Engaging in Binge Drinking

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 

Alabama 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). 0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

Proportion Using in Past Month

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.
4

Alabama Alabama Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Alabamians

In 2012, there were 1,255 admissions 

of Alabamians ages 50 and older to 

substance use disorder (SUD) treatment 

in state-funded treatment programs, 

a rate of 73.0 per 100,000 people ages 

50+. This rate was lower than the 

regional rate and the national average. 

Men made up 75.7 percent of these 

admissions. Of all admissions, 

51.3 percent were White/Caucasian, 

47.3 percent were Black/African 

American, and 0.6 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were:

Self-Referral Criminal Justice Other

27.1% 49.1% 23.9%

120.4

212.4

383.2

32.8

78.6

120.3

0

50

100

150

200

250

300

350

400

450

Alabama Region 4 U.S.

Male Female

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Alabama, Region 4, and the United States by Sex, 2012

SUD Admission Rate per 100,000 Population

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 Alabamians Ages 50+ by Insurance Type 

In Alabama, 57.2 percent of older 

adult admissions to SUD treatment 

were uninsured, 17.5 percent had 

Medicaid, 20.1 percent had Medicare, 

and 5.1 percent had private insurance.

SUD Treatment Admissions Among 

Alabamians Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

24.8% 13.0% 62.2%

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.

5.1%

17.5% 20.1%

57.2%

6.8%

11.2% 10.0%

72.1%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

Alabama Region 4 U.S.

Exhibit 8. SUD Treatment Admissions of Adults Ages 

50+ in Alabama, Region 4, and the United States by 

Insurance Type, 2012

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

Source: TEDS, 2012

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

5

Alcohol Use Disorder Treatment Admissions Among Alabamians Ages 50+

Alcohol was the most frequently cited 

substance used by older Alabamians 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 57.6 percent of admissions 

among those ages 50+. This was lower 

than the regional and national rates.

57.6%

63.9% 62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Alabama Region 4 U.S.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Alabama, Region 4, and the United States, 

2012

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

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 42.4 percent of older adult 

admissions to publicly funded 

treatment in Alabama. 42.4%

36.1%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Alabama Region 4 U.S.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Alabama, Region 4, 

and the United States, 2012

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

Alabama Alabama 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 Alabamians 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 Alabamians 

ages 50+ with a co-occurring mental 

disorder. This rate is lower than the 

regional rate and the national average. 

However, state reporting practices are 

a factor in these results.

23.8%

27.1%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Alabama Region 4 U.S.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Alabama, Region 4, 

and the United States, 2012

Source: TEDS, 2012

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

7

MENTAL HEALTH

Older Alabamians 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 Alabamians experience FMD at a 

rate that is higher than the regional and 

national rates. 

14.6%

18.0%

9.5%

12.9%

14.7%

8.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

18 to 49 50 to 64 65+

Alabama Region 4 U.S.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Alabama, Region 4, and the United States, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Alabamians Reporting Frequent Mental Distress by Age Group and Sex

Older men in Alabama 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, 

22.2 percent of women in the 50–64 age 

group and 9.7 percent in the 65+ age 

group reported FMD, while 13.4 percent 

of men in the 50–64 age group and 

9.2 percent in the 65+ age group 

reported FMD. 10.6%

18.4%

13.4%

22.2%

9.2% 9.7%

0%

5%

10%

15%

20%

25%

Male Female

18 to 49 50 to 64 65+

Exhibit 13. Alabamians Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Alabama Alabama 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 Alabamians.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 9.3% 8.3% 10.7%

Dissatisfied or very 

dissatisfied 6.0% 7.6% 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.

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 Alabama 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.

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

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older Alabamians Admitted to State Mental Health Services

Approximately 5.7 percent of the people served by the Alabama mental health system were ages 65 and 

older. This represents more than 5,350 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014
10 Alabama Alabama 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

Florida
 
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

FLORIDA’S POPULATION

Florida Population by Age Group

Florida is home to 19,893,297 people. Of 

these:

• 7,795,232 (39.2 percent) are over age 50.

• 5,017,302 (25.2 percent) are over age 60.

• 2,633,488 (13.2 percent) are over age 70.

• 1,020,702 (5.1 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 59.1 percent of the 80+ group. 

The racial/ethnic composition of older 

Floridians is as follows:

Race/Ethnicity of Floridians 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

85.2% 0.4% 11.4% 2.1% 0.1% 0.8% 16.8%

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. Florida Population by Age Group, 2014

1,130 1,183

1,334

1,196 1,268 1,339

1,113

744

418

1,081

1,126

1,280

1,203

1,298

1,439

1,271

869

603

0

500

1,000

1,500

2,000

2,500

3,000

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

Population in 1,000s

Male Female

Source: U.S. Census Bureau, 2015

The Number of Older Floridians Is Growing

The proportion of Florida’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 27.1 percent of Florida’s 

population will be 65 and older by the 

year 2030, an increase of 87.9 percent 

from 2015.

Projected Population in Florida

Age Group 2015 2025 2030

Under 18 21.0% 20.5% 20.1%

18 to 44 31.2% 29.8% 29.4%

45 to 64 28.3% 25.1% 23.4%

65+ 19.5% 24.7% 27.1%

Source: U.S. Census Bureau, 2005 0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

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

Population in 1,000s

August 2016

Florida
2

Florida Florida Profile 2016

SUICIDE AMONG OLDER FLORIDIANS

Florida Suicide Rate Compared With Regional and National Rates

The suicide rate among Floridians 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 (8.7 

for women and 35.2 for men). The rate 

among those ages 50–64 was higher than 

both the rate in the region (including 

Alabama, Georgia, Kentucky, Mississippi, 

North Carolina, South Carolina, and 

Tennessee) and the rate in the United 

States. 

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

15.0

11.2

22.1

19.7

14.2

11.4

20.8

18.1

13.0

10.6

19.0

16.1

0

5

10

15

20

25

All Under 50 50 to 64 65+

Florida Region 4 U.S.

Exhibit 3. Suicide Rates in Florida, Region 4, and the 

United States, 2013

Suicide Rate per 100,000 Population

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 Florida

The suicide rate among Floridians 

ages 50+ fluctuated from a low of 

17.6 per 100,000 in 2005 to a high of 

21.9 per 100,000 in 2012. 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.

0

5

10

15

20

25

30

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

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

2004–2013

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 Florida Florida Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER FLORIDIANS

30-Day Binge Drinking Among Older Floridians

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, 16.6 percent of Florida 

men ages 50–64 reported binge drinking 

in the past 30 days, while 6.3 percent of 

those in the 65+ group reported similar 

behavior. 

31.0%

16.6% 

6.3%

13.7%

10.2%

3.0%

0%

5%

10%

15%

20%

25%

30%

35%

18 to 49 50 to 64 65+

Male Female

Exhibit 5. Binge Drinking Rates in Florida by Age Group 

and Sex, 2013

Proportion of Population Engaging in Binge Drinking

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 

Florida 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). 0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

Proportion Using in Past Month

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.
4

Florida Florida Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Floridians

In 2012, there were 8,159 admissions 

of Floridians ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 104.7 per 100,000 

people ages 50+. This rate was lower 

than the regional rate and the national 

average. Men made up 70.6 percent of 

these admissions. Of all admissions, 

79.9 percent were White/Caucasian, 

17.6 percent were Black/African 

American, and 6.1 percent were 

Hispanic. 

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

52.1% 25.9% 22.0%

159.4

212.4

383.2

57.3

78.6

120.3

0

50

100

150

200

250

300

350

400

450

Florida Region 4 U.S.

Male Female

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Florida, Region 4, and the United States by Sex, 2012

SUD Admission Rate per 100,000 Population

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 4 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 Florida 

in 2012. Therefore, the rates for Region 4 

are used instead.

In Region 4, 72.1 percent of older 

adult admissions to SUD treatment 

were uninsured, 11.2 percent had 

Medicaid, 10.0 percent had Medicare, 

and 6.8 percent had private insurance.

SUD Treatment Admissions Among 

Floridians 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.

6.8%

11.2% 10.0%

72.1%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

Region 4 U.S.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Region 4 and the United States by Insurance Type, 2012

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

Source: TEDS, 2012

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

5

Alcohol Use Disorder Treatment Admissions Among Floridians Ages 50+

Alcohol was the most frequently cited 

substance used by older Floridians in 

publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 68.1 percent of admissions 

among those ages 50+. This was 

higher than the regional and national 

rates.

68.1%

63.9% 62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Florida Region 4 U.S.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Florida, Region 4, and the United States, 2012

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

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 31.9 percent of older adult 

admissions to publicly funded 

treatment in Florida.

31.9%

36.1%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Florida Region 4 U.S.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Florida, Region 4, 

and the United States, 2012

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

Florida Florida 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 Floridians 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 

Floridians ages 50+ with a co-occurring 

mental disorder. This rate is lower than 

the regional rate and the national 

average. However, state reporting 

practices are a factor in these results.

10.8%

27.1%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Florida Region 4 U.S.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Florida, Region 4, 

and the United States, 2012

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders

Source: TEDS, 2012

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

7

MENTAL HEALTH

Older Floridians 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 Floridians experience FMD at a 

rate that is higher than the regional and 

national rates.

13.2%

15.7%

8.4%

12.9%

14.7%

8.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

18 to 49 50 to 64 65+

Florida Region 4 U.S.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Florida, Region 4, and the United States, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Floridians Reporting Frequent Mental Distress by Age Group and Sex

Older men in Florida 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, 

17.5 percent of women in the 50–64 age 

group and 9.3 percent in the 65+ age 

group reported FMD, while 13.8 percent 

of men in the 50–64 age group and 

7.2 percent in the 65+ age group 

reported FMD.

11.1%

15.4%

13.8%

17.5%

7.2%

9.3%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

Male Female

18 to 49 50 to 64 65+

Exhibit 13. Floridians Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Florida Florida 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 Floridians.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 10.5% 9.7% 11.5%

Dissatisfied or very 

dissatisfied 6.5% 8.9% 3.6%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical 

health.

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 Florida Florida 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.

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

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older Floridians Admitted to State Mental Health Services

Approximately 4.1 percent of the people served by the Florida mental health system were ages 65 and 

older. This represents more than 9,410 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014
10 Florida Florida 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

Georgia
 
August 2016

OLDER ADULTS BEHAVIORAL HEALTH PROFILE

GEORGIA’S POPULATION

Georgia Population by Age Group

Georgia is home to 10,097,343 people. 

Of these:

• 3,136,853 (31.1 percent) are over age 50.

• 1,792,655 (17.8 percent) are over age 60.

• 798,387 (7.9 percent) are over age 70.

• 271,418 (2.7 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 64.1 percent of the 80+ group. 

The racial/ethnic composition of older 

Georgians is as follows:

Race/Ethnicity of Georgians 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

69.7% 0.3% 26.2% 2.9% 0.1% 0.8% 3.7%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

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

Exhibit 1. Georgia Population by Age Group, 2014

697 717 729

657 683 648

463

235

97

670 689 709

692 717 696

531

292

174

0

200

400

600

800

1,000

1,200

1,400

1,600

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

Population in 1,000s

Male Female

Source: U.S. Census Bureau, 2015

The Number of Older Georgians Is Growing

The proportion of Georgia’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 15.9 percent of Georgia’s 

population will be 65 and older by the 

year 2030, an increase of 60.6 percent 

from 2015.

Projected Population in Georgia

Age Group 2015 2025 2030

Under 18 26.2% 26.1% 26.2%

18 to 44 37.4% 35.8% 35.5%

45 to 64 24.9% 23.6% 22.5%

65+ 11.6% 14.5% 15.9%

Source: U.S. Census Bureau, 2005

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

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

Population in 1,000s

Georgia
2

Georgia Georgia Profile 2016

SUICIDE AMONG OLDER GEORGIANS

Georgia Suicide Rate Compared With Regional and National Rates

The suicide rate among Georgians 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 17.0 per 100,000 people (7.5 

for women and 28.2 for men). The rate 

among those ages 50–64 was lower than 

both the rate in the region (including 

Alabama, Florida, Kentucky, Mississippi, 

North Carolina, South Carolina, and 

Tennessee) and the rate in the United 

States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

12.1

10.0

18.0

15.5

14.2

11.4

20.8

18.1

13.0

10.6

19.0

16.1

0

5

10

15

20

25

All Under 50 50 to 64 65+

Georgia Region 4 U.S.

Exhibit 3. Suicide Rates in Georgia, Region 4, and the 

United States, 2013

Suicide Rate per 100,000 Population

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 Georgia

The suicide rate among Georgians 

ages 50+ fluctuated from a low of 

15.4 per 100,000 in 2006 to a high 

of 18.1 per 100,000 in 2009. 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.

0

2

4

6

8

10

12

14

16

18

20

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

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

2004–2013

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 Georgia Georgia Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER GEORGIANS

30-Day Binge Drinking Among Older Georgians

Binge drinking, defined as five or more 

drinks for men and four or more drinks 

for women on a single occasion, can 

lead to serious health problems. Such 

problems include neurological damage, 

cardiovascular disease, liver disease, 

stroke, and poor control of diabetes. 

Binge drinkers are more likely to take 

risks such as driving while intoxicated and 

to experience falls and other accidents. 

Older people have a lower tolerance for 

alcohol. Binge drinking decreases with 

age and occurs more frequently among 

men than it does among women. As 

Exhibit 5 shows, 13.8 percent of Georgia 

men ages 50–64 reported binge drinking 

in the past 30 days, while 5.4 percent of 

those in the 65+ group reported similar 

behavior. 

21.8%

13.8% 

5.4%

13.1%

6.1%

1.9%

0%

5%

10%

15%

20%

25%

18 to 49 50 to 64 65+

Male Female

Exhibit 5. Binge Drinking Rates in Georgia by Age Group 

and Sex, 2013

Proportion of Population Engaging in Binge Drinking

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 

Georgia 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). 0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

Proportion Using in Past Month

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.
4

Georgia Georgia Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Georgians

In 2012, there were 8,164 admissions 

of Georgians ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 260.3 per 100,000 

people ages 50+. This rate was higher 

than the regional rate and the national 

average. Men made up 63.0 percent of 

these admissions. Of all admissions, 

50.3 percent were White/Caucasian, 

48.3 percent were Black/African 

American, and 1.6 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

44.5% 11.1% 44.4%

356.3

212.4

383.2

178.4

78.6

120.3

0

50

100

150

200

250

300

350

400

450

Georgia Region 4 U.S.

Male Female

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Georgia, Region 4, and the United States by Sex, 2012

SUD Admission Rate per 100,000 Population

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 4 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 

Georgia in 2012. Therefore, the rates for 

Region 4 are used instead.

In Region 4, 72.1 percent of older 

adult admissions to SUD treatment 

were uninsured, 11.2 percent had 

Medicaid, 10.0 percent had Medicare, 

and 6.8 percent had private insurance.

SUD Treatment Admissions Among 

Georgians 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.

6.8%

11.2% 10.0%

72.1%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

Region 4 U.S.

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

Region 4 and the United States by Insurance Type, 2012

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

Source: TEDS, 2012

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

5

Alcohol Use Disorder Treatment Admissions Among Georgians Ages 50+

Alcohol was the most frequently cited 

substance used by older Georgians 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 61.0 percent of admissions 

among those ages 50+. This was lower 

than the regional and national rates. 61.0%

63.9% 62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Georgia Region 4 U.S.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Georgia, Region 4, and the United States, 

2012

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

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 39.0 percent of older adult 

admissions to publicly funded 

treatment in Georgia.

39.0%

36.1%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Georgia Region 4 U.S.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Georgia, Region 4, 

and the United States, 2012

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

Georgia Georgia 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 4 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 Georgia in 2012. Therefore, 

Exhibit 11 shows regional and 

national figures only.

27.1%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Region 4 U.S.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Region 4 and the 

United States, 2012

Source: TEDS, 2012

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

7

MENTAL HEALTH

Older Georgians 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 Georgians experience FMD at a 

rate that is lower than the regional and 

national rates. 

11.3%

12.0%

6.4%

12.9%

14.7%

8.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18 to 49 50 to 64 65+

Georgia Region 4 U.S.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Georgia, Region 4, and the United States, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Georgians Reporting Frequent Mental Distress by Age Group and Sex

Older men in Georgia 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, 

13.1 percent of women in the 50–64 age 

group and 7.0 percent in the 65+ age 

group reported FMD, while 10.8 percent 

of men in the 50–64 age group and 

5.6 percent in the 65+ age group 

reported FMD.

9.9%

12.6%

10.8%

13.1%

5.6%

7.0%

0%

2%

4%

6%

8%

10%

12%

14%

Male Female

18 to 49 50 to 64 65+

Exhibit 13. Georgians Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Georgia Georgia 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 Georgians.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 8.6% 7.3% 10.9%

Dissatisfied or very 

dissatisfied 4.6% 5.5% 3.1%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical 

health.

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 Georgia Georgia 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.

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

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older Georgians Admitted to State Mental Health Services

Approximately 2.8 percent of the people served by the Georgia mental health system were ages 65 and 

older. This represents more than 4,630 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014
10 Georgia Georgia 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

Kentucky
 
August 2016

OLDER ADULTS BEHAVIORAL HEALTH PROFILE

KENTUCKY’S POPULATION

Kentucky Population by Age Group

Kentucky is home to 4,413,457 people. 

Of these:

• 1,551,990 (35.2 percent) are over age 50.

• 924,967 (21.0 percent) are over age 60.

• 430,224 (9.7 percent) are over age 70.

• 154,734 (3.5 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 63.6 percent of the 80+ group. 

The racial/ethnic composition of older 

Kentuckians is as follows:

Race/Ethnicity of Kentuckians 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

91.9% 0.3% 6.4% 0.8% 0.0% 0.7% 1.2%

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. Kentucky Population by Age Group, 2014

286 291 305 280 288 306

237

124

56

272 277

293

279 290

321

258

151

98

0

100

200

300

400

500

600

700

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

Population in 1,000s

Male Female

Source: U.S. Census Bureau, 2015

The Number of Older Kentuckians Is Growing

The proportion of Kentucky’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 

19.8 percent of Kentucky’s population 

will be 65 and older by the year 2030, 

an increase of 41.8 percent from 2015.

Projected Population in Kentucky

Age Group 2015 2025 2030

Under 18 23.1% 22.5% 22.6%

18 to 44 35.1% 34.0% 33.6%

45 to 64 27.1% 25.1% 24.0%

65+ 14.6% 18.4% 19.8%

Source: U.S. Census Bureau, 2005

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

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

Population in 1,000s

Kentucky
2

Kentucky Kentucky Profile 2016

SUICIDE AMONG OLDER KENTUCKIANS

Kentucky Suicide Rate Compared With Regional and National Rates

The suicide rate among Kentuckians 

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 20.2 per 100,000 people (8.0 

for women and 34.2 for men). The rate 

among those ages 50–64 was higher than 

both the rate in the region (including 

Alabama, Florida, Georgia, Mississippi, 

North Carolina, South Carolina, and 

Tennessee) and the rate in the United 

States. 

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

15.9

13.7

21.0

19.1

14.2

11.4

20.8

18.1

13.0

10.6

19.0

16.1

0

5

10

15

20

25

All Under 50 50 to 64 65+

Kentucky Region 4 U.S.

Exhibit 3. Suicide Rates in Kentucky, Region 4, and the 

United States, 2013

Suicide Rate per 100,000 Population

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 Kentucky

The suicide rate among Kentuckians 

ages 50+ fluctuated from a low of 

15.5 per 100,000 in 2005 to a high of 

20.2 per 100,000 in 2012 and 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.

0

5

10

15

20

25

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

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

2004–2013

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 Kentucky Kentucky Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER KENTUCKIANS

30-Day Binge Drinking Among Older Kentuckians

Binge drinking, defined as five or more 

drinks for men and four or more drinks 

for women on a single occasion, can 

lead to serious health problems. Such 

problems include neurological damage, 

cardiovascular disease, liver disease, 

stroke, and poor control of diabetes. 

Binge drinkers are more likely to take risks 

such as driving while intoxicated and to 

experience falls and other accidents. Older 

people have a lower tolerance for alcohol. 

Binge drinking decreases with age and 

occurs more frequently among men than 

it does among women. As Exhibit 5 shows, 

13.0 percent of Kentucky 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. 

25.3%

13.0%

5.9%

13.4%

5.8%

1.1%

0%

5%

10%

15%

20%

25%

30%

18 to 49 50 to 64 65+

Male Female

Exhibit 5. Binge Drinking Rates in Kentucky by Age 

Group and Sex, 2013

Proportion of Population Engaging in Binge Drinking

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 

Kentucky 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). 0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

Proportion Using in Past Month

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.
4

Kentucky Kentucky Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Kentuckians

In 2012, there were 1,681 admissions 

of Kentuckians ages 50 and older to 

substance use disorder (SUD) treatment 

in state-funded treatment programs, 

a rate of 108.3 per 100,000 people 

ages 50+. This rate was lower than the 

regional rate and the national average. 

Men made up 75.9 percent of these 

admissions. Of all admissions, 

79.1 percent were White/Caucasian, 

19.3 percent were Black/African 

American, and 0.8 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

53.8% 29.7% 16.6%

176.2

212.4

383.2

48.9

78.6

120.3

0

50

100

150

200

250

300

350

400

450

Kentucky Region 4 U.S.

Male Female

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Kentucky, Region 4, and the United States by Sex, 2012

SUD Admission Rate per 100,000 Population

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 Kentuckians Ages 50+ by Insurance Type 

In Kentucky, 86.7 percent of older adult 

admissions to SUD treatment were 

uninsured, 4.0 percent had Medicaid, 

6.3 percent had Medicare, and 3.0 

percent had private insurance.

SUD Treatment Admissions Among 

Kentuckians Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

10.2% 4.0% 85.7%

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.

3.0% 4.0% 6.3%

86.7%

6.8%

11.2% 10.0%

72.1%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Private Medicaid Medicare None

Kentucky Region 4 U.S.

Exhibit 8. SUD Treatment Admissions of Adults Ages 

50+ in Kentucky, Region 4, and the United States by 

Insurance Type, 2012

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

Source: TEDS, 2012

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

5

Alcohol Use Disorder Treatment Admissions Among Kentuckians Ages 50+

Alcohol was the most frequently cited 

substance used by older Kentuckians 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 62.1 percent of admissions 

among those ages 50+. This was lower 

than the regional rate and equal to the 

national rate. 62.1% 63.9% 62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Kentucky Region 4 U.S.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Kentucky, Region 4, and the United States, 

2012

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

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 37.9 percent of older adult 

admissions to publicly funded 

treatment in Kentucky. 37.9%

36.1%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Kentucky Region 4 U.S.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Kentucky, Region 4, 

and the United States, 2012

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

Kentucky Kentucky 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 Kentuckians 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 Kentuckians 

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.

45.1%

27.1%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Kentucky Region 4 U.S.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Kentucky, Region 4, 

and the United States, 2012

Source: TEDS, 2012

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

7

MENTAL HEALTH

Older Kentuckians 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 Kentuckians experience FMD at a 

rate that is higher than the regional and 

national rates. 

15.1%

15.8%

10.0%

12.9%

14.7%

8.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

18 to 49 50 to 64 65+

Kentucky Region 4 U.S.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Kentucky, Region 4, and the United States, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Kentuckians Reporting Frequent Mental Distress by Age Group and Sex

Older men in Kentucky 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, 

19.3 percent of women in the 50–64 age 

group and 10.3 percent in the 65+ age 

group reported FMD, while 12.1 percent 

of men in the 50–64 age group and 

9.6 percent in the 65+ age group 

reported FMD. 12.7%

17.6%

12.1%

19.3%

9.6% 10.3%

0%

5%

10%

15%

20%

25%

Male Female

18 to 49 50 to 64 65+

Exhibit 13. Kentuckians Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Kentucky Kentucky 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 Kentuckians.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 8.5% 7.2% 10.4%

Dissatisfied or very 

dissatisfied 6.9% 9.1% 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.

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 Kentucky Kentucky 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.

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

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older Kentuckians Admitted to State Mental Health Services

Approximately 3.1 percent of the people served by the Kentucky mental health system were ages 65 and 

older. This represents more than 4,840 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014
10 Kentucky Kentucky 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

Mississippi
 
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

MISSISSIPPI’S POPULATION

Mississippi Population by Age Group

Mississippi is home to 2,994,079 people. 

Of these:

• 1,006,249 (33.6 percent) are over age 50.

• 602,026 (20.1 percent) are over age 60.

• 284,378 (9.5 percent) are over age 70.

• 101,589 (3.4 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 64.9 percent of the 80+ group. 

The racial/ethnic composition of older 

Mississippians is as follows:

Race/Ethnicity of Mississippians 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

67.9% 0.4% 30.4% 0.7% 0.0% 0.5% 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. Mississippi Population by Age Group, 2014

206 210 212

185 180 194

150

81

36

197 202 211

193 192

210

168

102

66

0

50

100

150

200

250

300

350

400

450

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

Population in 1,000s

Male Female

Source: U.S. Census Bureau, 2015

The Number of Older Mississippians Is Growing

The proportion of Mississippi’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 

20.5 percent of Mississippi’s population 

will be 65 and older by the year 2030, 

an increase of 46.3 percent from 2015.

Projected Population in Mississippi

Age Group 2015 2025 2030

Under 18 25.0% 23.4% 23.0%

18 to 44 34.1% 32.2% 31.4%

45 to 64 26.6% 25.7% 25.1%

65+ 14.4% 18.7% 20.5%

Source: U.S. Census Bureau, 2005 0

200

400

600

800

1,000

1,200

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

Exhibit 2. Mississippi Population by Age Group, 2000–

2030

Population in 1,000s

August 2016

Mississippi
2

Mississippi Mississippi Profile 2016

SUICIDE AMONG OLDER MISSISSIPPIANS

Mississippi Suicide Rate Compared With Regional and National Rates

The suicide rate among Mississippians 

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 16.4 per 100,000 people (6.1 

for women and 28.4 for men). The rate 

among those ages 50–64 was lower than 

both the rate in the region (including 

Alabama, Florida, Georgia, Kentucky, 

North Carolina, South Carolina, and 

Tennessee) and the rate in the United 

States. 

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

13.0

11.3

17.9

14.2 14.2

11.4

20.8

18.1

13.0

10.6

19.0

16.1

0

5

10

15

20

25

All Under 50 50 to 64 65+

Mississippi Region 4 U.S.

Exhibit 3. Suicide Rates in Mississippi, Region 4, and the 

United States, 2013

Suicide Rate per 100,000 Population

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 Mississippi

The suicide rate among Mississippians 

ages 50+ fluctuated from a low of 14.4 

per 100,000 in 2005 to a high of 19.1 

per 100,000 in 2008. 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.

0

5

10

15

20

25

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Exhibit 4. Trends in Suicide Rates in Mississippi by Age 

Group, 2004–2013

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 Mississippi Mississippi Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER MISSISSIPPIANS

30-Day Binge Drinking Among Older Mississippians

Binge drinking, defined as five or more 

drinks for men and four or more drinks 

for women on a single occasion, can 

lead to serious health problems. Such 

problems include neurological damage, 

cardiovascular disease, liver disease, 

stroke, and poor control of diabetes. 

Binge drinkers are more likely to take risks 

such as driving while intoxicated and to 

experience falls and other accidents. Older 

people have a lower tolerance for alcohol. 

Binge drinking decreases with age and 

occurs more frequently among men than 

it does among women. As Exhibit 5 shows, 

13.6 percent of Mississippi men ages 

50–64 reported binge drinking in the past 

30 days, while 5.2 percent of those in the 

65+ group reported similar behavior. 

21.3%

13.6% 

5.2%

12.2%

7.2%

1.5% 0%

5%

10%

15%

20%

25%

18 to 49 50 to 64 65+

Male Female

Exhibit 5. Binge Drinking Rates in Mississippi by Age 

Group and Sex, 2013

Proportion of Population Engaging in Binge Drinking

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 Mississippi 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). 0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

Proportion Using in Past Month

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.
4

Mississippi Mississippi Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Adults in Region 4

Treatment Episode Data Set (TEDS) data 

for Mississippi in 2012 are unavailable. 

Therefore, data for Region 4 are used 

instead.

In 2012, there were 30,369 admissions of 

individuals in Region 4 ages 50 and older 

to substance use disorder (SUD) treatment 

in state-funded treatment programs, a 

rate of 140.4 per 100,000 people ages 

50+. This rate was lower than the national 

average. Men made up 69.9 percent of 

these admissions. Of all admissions, 

62.9 percent were White/Caucasian, 

35.0 percent were Black/African 

American, and 3.5 percent were Hispanic. 

The principal sources of referral to 

treatment among those ages 50 and older 

were:

Self-Referral Criminal Justice Other

44.7% 24.1% 31.1%

212.4

383.2

78.6

120.3

0

50

100

150

200

250

300

350

400

450

Region 4 U.S.

Male Female

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Region 4 and the United States by Sex, 2012

SUD Admission Rate per 100,000 Population

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 4 Ages 50+ by Insurance Type 

TEDS data for Mississippi in 2012 are 

unavailable. Therefore, data for Region 4 

are used instead.

In Region 4, 72.1 percent of older 

adult admissions to SUD treatment 

were uninsured, 11.2 percent had 

Medicaid, 10.0 percent had Medicare, 

and 6.8 percent had private insurance.

SUD Treatment Admissions Among 

Mississippians 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.

6.8%

11.2% 10.0%

72.1%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

Region 4 U.S.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Region 4 and the United States by Insurance Type, 2012

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

Source: TEDS, 2012

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

5

Alcohol Use Disorder Treatment Admissions Among Individuals in Region 4 Ages 50+

TEDS data for Mississippi in 2012 

are unavailable. Therefore, data for 

Region 4 are used instead.

Alcohol was the most frequently cited 

substance used by older individuals 

in Region 4 in publicly financed SUD 

treatment in 2012. It was mentioned 

as a substance of use in 63.9 percent 

of admissions among those ages 50+. 

This was higher than the national rate.

63.9% 62.1%

0%

10%

20%

30%

40%

50%

60%

70%

Region 4 U.S.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Region 4 and the United States, 2012

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions for Non-Alcohol Substance Use

TEDS data for Mississippi in 2012 

are unavailable. Therefore, data for 

Region 4 are used instead.

Substances other than alcohol were 

cited as the primary substances of 

use for 36.1 percent of older adult 

admissions to publicly funded 

treatment in Region 4.

36.1%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Region 4 U.S.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Region 4 and the 

United States, 2012

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

Mississippi Mississippi 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 4 in SUD Treatment With Co-Occurring Mental Disorders

The national literature shows a strong 

relationship between substance use 

and mental disorders. Studies show 

that 30–80 percent of individuals with a 

substance use or mental disorder also 

have a co-occurring disorder.

TEDS data for Mississippi in 2012 

are unavailable. Therefore, Exhibit 11 

shows regional and national figures 

only.

27.1%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Region 4 U.S.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Region 4 and the 

United States, 2012

Source: TEDS, 2012

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

7

MENTAL HEALTH

Older Mississippians 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 

Mississippians in the 50‒64 age group 

experience FMD at a rate higher than the 

regional and national rates, while those 

in the 65+ age group experience it at 

a rate lower than the regional rate and 

higher than the national rate. 

15.0%

17.1%

7.8%

12.9%

14.7%

8.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

18 to 49 50 to 64 65+

Mississippi Region 4 U.S.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Mississippi, Region 4, and the United States, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Mississippians Reporting Frequent Mental Distress by Age Group and Sex

Older men in Mississippi 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, 

21.0 percent of women in the 50–64 age 

group and 8.3 percent in the 65+ age 

group reported FMD, while 12.7 percent 

of men in the 50–64 age group and 

7.1 percent in the 65+ age group 

11.3% reported FMD.

18.7%

12.7%

21.0%

7.1%

8.3%

0%

5%

10%

15%

20%

25%

Male Female

18 to 49 50 to 64 65+

Exhibit 13. Mississippians Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Mississippi Mississippi 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 Mississippians.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 10.8% 10.7% 10.9%

Dissatisfied or very 

dissatisfied 4.6% 5.7% 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.

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 Mississippi Mississippi 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.

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

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older Mississippians Admitted to State Mental Health Services

Approximately 4.8 percent of the people served by the Mississippi mental health system were ages 65 and 

older. This represents more than 4,360 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014
10 Mississippi Mississippi 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

North Carolina
 
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

NORTH CAROLINA’S POPULATION

North Carolina Population by Age Group

North Carolina is home to 9,943,964 people. 

Of these:

• 3,405,148 (34.2 percent) are over age 50.

• 2,047,581 (20.6 percent) are over age 60.

• 957,893 (9.6 percent) are over age 70.

• 344,002 (3.5 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 63.9 percent of the 80+ group. 

The racial/ethnic composition of older 

North Carolinians is as follows:

Race/Ethnicity of North Carolinians 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

77.5% 1.1% 19.0% 1.6% 0.0% 0.7% 3.0%

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. North Carolina Population by Age Group, 

2014

639 666 700

618 659 653

510

275

124

613 639

673

645

687 705

580

339

220

0

200

400

600

800

1,000

1,200

1,400

1,600

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

Population in 1,000s

Male Female

Source: U.S. Census Bureau, 2015

The Number of Older North Carolinians Is Growing

The proportion of North Carolina’s 

population that is 65 and older is 

growing while the proportion that is 

younger than 65 is shrinking. The U.S. 

Census Bureau estimates that 

17.8 percent of North Carolina’s 

population will be 65 and older by the 

year 2030, an increase of 58.1 percent 

from 2015.

Projected Population in North Carolina

Age Group 2015 2025 2030

Under 18 24.4% 24.8% 25.2%

18 to 44 35.8% 34.5% 34.6%

45 to 64 26.1% 24.2% 22.4%

65+ 13.7% 16.6% 17.8%

Source: U.S. Census Bureau, 2005

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

Exhibit 2. North Carolina Population by Age Group, 

2000–2030

Population in 1,000s

August 2016

North Carolina
2

North Carolina North Carolina Profile 2016

SUICIDE AMONG OLDER NORTH CAROLINIANS

North Carolina Suicide Rate Compared With Regional and National Rates

The suicide rate among North Carolinians 

ages 50 and older is higher than the rate 

among younger age groups. In 2013, the 

total suicide rate among all people ages 

50+ was 18.0 per 100,000 people (7.3 

for women and 30.6 for men). The rate 

among those ages 50–64 was lower than 

the rate in the region (including Alabama, 

Florida, Georgia, Kentucky, Mississippi, 

South Carolina, and Tennessee) and 

higher than the rate in the United States. 

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

13.0

10.5

20.0

15.3

14.2

11.4

20.8

18.1

13.0

10.6

19.0

16.1

0

5

10

15

20

25

All Under 50 50 to 64 65+

Suicide Rate per 100,000 Population

North Carolina Region 4 U.S.

Exhibit 3. Suicide Rates in North Carolina, Region 4, 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 North Carolina

The suicide rate among North 

Carolinians ages 50+ fluctuated from 

a low of 14.1 per 100,000 in 2004 to 

a high of 18.9 per 100,000 in 2012. 

From 2004 to 2013, the rate was 

generally highest among those in the 

50‒64 age group. 

How a state reports suicides can vary 

from year to year. The number of 

suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

0

5

10

15

20

25

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Exhibit 4. Trends in Suicide Rates in North Carolina by Age 

Group, 2004–2013

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 North Carolina North Carolina Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER NORTH CAROLINIANS

30-Day Binge Drinking Among Older North Carolinians

Binge drinking, defined as five or more 

drinks for men and four or more drinks 

for women on a single occasion, can 

lead to serious health problems. Such 

problems include neurological damage, 

cardiovascular disease, liver disease, 

stroke, and poor control of diabetes. 

Binge drinkers are more likely to take risks 

such as driving while intoxicated and to 

experience falls and other accidents. Older 

people have a lower tolerance for alcohol. 

Binge drinking decreases with age and 

occurs more frequently among men than 

it does among women. As Exhibit 5 shows, 

12.0 percent of North Carolina 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. 

24.5%

12.0% 

5.3%

12.4%

6.5%

1.9% 0%

5%

10%

15%

20%

25%

30%

18 to 49 50 to 64 65+

Male Female

Exhibit 5. Binge Drinking Rates in North Carolina by Age 

Group and Sex, 2013

Proportion of Population Engaging in Binge Drinking

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 North Carolina 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). 0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

Proportion Using in Past Month

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.
4

North Carolina North Carolina Profile 2016

Admissions to Substance Use Disorder Treatment Among Older North Carolinians

In 2012, there were 7,004 admissions of 

North Carolinians ages 50 and older to 

substance use disorder (SUD) treatment 

in state-funded treatment programs, 

a rate of 205.7 per 100,000 people 

ages 50+. This rate was higher than 

the regional rate and lower than the 

national average. Men made up 

71.9 percent of these admissions. Of all 

admissions, 57.3 percent were White/

Caucasian, 40.0 percent were Black/

African American, and 1.0 percent were 

Hispanic. 

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

43.1% 19.9% 37.0%

322.1

212.4

383.2

106.9

78.6

120.3

0

50

100

150

200

250

300

350

400

450

North Carolina Region 4 U.S.

Male Female

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

North Carolina, Region 4, and the United States by Sex, 2012

SUD Admission Rate per 100,000 Population

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 North Carolinians Ages 50+ by Insurance Type 

In North Carolina, 75.8 percent of older 

adult admissions to SUD treatment were 

uninsured, 18.7 percent had Medicare, 

and 5.5 percent had private insurance. 

There were no reported Medicaid 

admissions. 

SUD Treatment Admissions Among 

North Carolinians 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 North Carolina, Region 4, and the United States by 

Insurance Type, 2012

eypce T

80%

an

75.8%

y Insur

70% 72.1%

es 50+ b

60%

lts Agu

50% 53.9%

s of Ad mission

40%

t Ad

30%

tmenea

20%

 of SUD Tr

20.4% 18.7%

14.9% 10% 11.2% 10.0% 10.8%

on

6.8%

orti

5.5% 0.0% 0%

oprP

Private Medicaid Medicare None

North Carolina Region 4 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
Alabama ALABAMA Profile 2015 North Carolina North Carolina Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among North Carolinians Ages 50+

Alcohol was the most frequently 

cited substance used by older North 

Carolinians in publicly financed SUD 

treatment in 2012. It was mentioned 

as a substance of use in 59.8 percent 

of admissions among those ages 50+. 

This was lower than the regional and 

national rates. 59.8%

63.9% 62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

North Carolina Region 4 U.S.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in North Carolina, Region 4, and the United 

States, 2012

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

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 40.2 percent of older adult 

admissions to publicly funded 

treatment in North Carolina.

40.2%

36.1%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

North Carolina Region 4 U.S.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in North Carolina, 

Region 4, and the United States, 2012

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

North Carolina North Carolina 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 North Carolinians 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 North 

Carolinians 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.

43.1%

27.1%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

North Carolina Region 4 U.S.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in North Carolina, 

Region 4, and the United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
Alabama ALABAMA Profile 2015 North Carolina North Carolina Profile 2016

7

MENTAL HEALTH

Older North Carolinians 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 as experiencing frequent 

mental distress (FMD). Exhibit 12 shows 

that North Carolinians in the 50‒64 

age group experience FMD at a rate 

lower than the regional and national 

rates, while those in the 65+ age group 

experience it at a rate lower than the 

regional rate and higher than the 

national rate. 

12.5% 12.7%

7.8%

12.9%

14.7%

8.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18 to 49 50 to 64 65+

North Carolina Region 4 U.S.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in North Carolina, Region 4, and the United States, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older North Carolinians Reporting Frequent Mental Distress by Age Group 

and Sex

Older men in North Carolina 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, 

14.7 percent of women in the 50–64 age 

group and 8.7 percent in the 65+ age 

group reported FMD, while 10.5 percent 

of men in the 50–64 age group and 

6.6 percent in the 65+ age group 

reported FMD.

9.5%

15.6%

10.5%

14.7%

6.6%

8.7%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

Male Female

18 to 49 50 to 64 65+

Exhibit 13. North Carolinians Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

North Carolina North Carolina 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 North Carolinians.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 9.1% 8.1% 10.4%

Dissatisfied or very 

dissatisfied 4.5% 5.7% 2.7%

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.

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 North Carolina North Carolina 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.

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

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older North Carolinians Admitted to State Mental Health Services

Approximately 3.2 percent of the people served by the North Carolina mental health system were ages 65 

and older. This represents more than 6,980 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014
10 North Carolina North Carolina 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

South Carolina
 
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

SOUTH CAROLINA’S POPULATION

South Carolina Population by Age Group

South Carolina is home to 4,832,482 people. 

Of these:

• 1,730,918 (35.8 percent) are over age 50.

• 1,065,420 (22.0 percent) are over age 60.

• 491,086 (10.2 percent) are over age 70.

• 165,978 (3.4 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 63.0 percent of the 80+ group. 

The racial/ethnic composition of older 

South Carolinians is as follows:

Race/Ethnicity of South Carolinians 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

74.4% 0.4% 23.5% 1.1% 0.0% 0.6% 2.0%

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. South Carolina Population by Age Group, 

2014

305 314 342

292 301 317

268

149

61

294 301

333

303 317

348

306

177

105

0

100

200

300

400

500

600

700

800

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

Population in 1,000s

Male Female

Source: U.S. Census Bureau, 2015

The Number of Older South Carolinians Is Growing

The proportion of South Carolina’s 

population that is 65 and older is 

growing while the proportion that is 

younger than 65 is shrinking. The U.S. 

Census Bureau estimates that 

22.0 percent of South Carolina’s 

population will be 65 and older by the 

year 2030, an increase of 55.6 percent 

from 2015.

Projected Population in South Carolina

Age Group 2015 2025 2030

Under 18 22.9% 22.3% 22.2%

18 to 44 34.0% 32.4% 32.0%

45 to 64 27.4% 25.1% 23.7%

65+ 15.7% 20.2% 22.0%

Source: U.S. Census Bureau, 2005

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

Exhibit 2. South Carolina Population by Age Group, 

2000–2030

Population in 1,000s

August 2016

South Carolina
2

South Carolina South Carolina Profile 2016

SUICIDE AMONG OLDER SOUTH CAROLINIANS

South Carolina Suicide Rate Compared With Regional and National Rates

The suicide rate among South Carolinians 

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 19.4 per 100,000 people (7.6 

for women and 33.4 for men). The rate 

among those ages 50–64 was lower than 

the rate in the region (including Alabama, 

Florida, Georgia, Kentucky, Mississippi, 

North Carolina, and Tennessee) and 

higher than the rate in the United States. 

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

14.6

11.9

20.4

18.1

14.2

11.4

20.8

18.1

13.0

10.6

19.0

16.1

0

5

10

15

20

25

All Under 50 50 to 64 65+

Suicide Rate per 100,000 Population

South Carolina Region 4 U.S.

Exhibit 3. Suicide Rates in South Carolina, Region 4, 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 South Carolina

The suicide rate among South 

Carolinians ages 50+ fluctuated from 

a low of 13.1 per 100,000 in 2005 to 

a high of 19.5 per 100,000 in 2012. 

From 2004 to 2013, the rate was 

generally highest among those in the 

50‒64 age group. 

How a state reports suicides can 

vary from year to year. The number 

of suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

0

5

10

15

20

25

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Exhibit 4. Trends in Suicide Rates in South Carolina by Age 

Group, 2004–2013

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 South Carolina South Carolina Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER SOUTH CAROLINIANS

30-Day Binge Drinking Among Older South Carolinians

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 South Carolina men ages 

50–64 reported binge drinking in the past 

30 days, while 7.4 percent of those in the 

65+ group reported similar behavior. 

27.7%

17.4% 

7.4%

13.8%

6.8%

2.2% 0%

5%

10%

15%

20%

25%

30%

18 to 49 50 to 64 65+

Male Female

Exhibit 5. Binge Drinking Rates in South Carolina by Age 

Group and Sex, 2013

Proportion of Population Engaging in Binge Drinking

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 South Carolina 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). 0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

Proportion Using in Past Month

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.
4

South Carolina South Carolina Profile 2016

Admissions to Substance Use Disorder Treatment Among Older South Carolinians

In 2012, there were 2,736 admissions 

of South Carolinians ages 50 and 

older to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 158.1 per 100,000 

people ages 50+. This rate was higher 

than the regional rate and lower than 

the national average. Men made up 

74.9 percent of these admissions. Of all 

admissions, 59.6 percent were White/

Caucasian, 38.9 percent were Black/

African American, and 0.9 percent were 

Hispanic. 

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

31.3% 45.6% 23.0%

257.7

212.4

383.2

73.3 78.6

120.3

0

50

100

150

200

250

300

350

400

450

South Carolina Region 4 U.S.

Male Female

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

South Carolina, Region 4, and the United States by Sex, 2012

SUD Admission Rate per 100,000 Population

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 South Carolinians Ages 50+ by Insurance Type 

In South Carolina, 59.7 percent of older 

adult admissions to SUD treatment 

were uninsured, 18.7 percent had 

Medicaid, 8.9 percent had Medicare, 

and 12.7 percent had private insurance.

SUD Treatment Admissions Among 

South Carolinians Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

79.8% 17.1% 3.1%

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.

12.7%

18.7%

8.9%

59.7%

6.8%

11.2% 10.0%

72.1%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

South Carolina Region 4 U.S.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in South Carolina, Region 4, and the United States by 

Insurance Type, 2012

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
Alabama ALABAMA Profile 2015 South Carolina South Carolina Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among South Carolinians Ages 50+

Alcohol was the most frequently 

cited substance used by older South 

Carolinians in publicly financed SUD 

treatment in 2012. It was mentioned 

as a substance of use in 76.1 percent 

of admissions among those ages 50+. 

This was higher than the regional and 

national rates.

76.1%

63.9% 62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

South Carolina Region 4 U.S.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in South Carolina, Region 4, and the United 

States, 2012

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

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 23.9 percent of older adult 

admissions to publicly funded 

treatment in South Carolina.

23.9%

36.1%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

South Carolina Region 4 U.S.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in South Carolina, 

Region 4, and the United States, 2012

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

South Carolina South Carolina 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 South Carolinians 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 South 

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

is lower than the regional rate and 

the national average. However, state 

reporting practices are a factor in 

these results.

16.3%

27.1%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

South Carolina Region 4 U.S.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in South Carolina, 

Region 4, and the United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
Alabama ALABAMA Profile 2015 South Carolina South Carolina Profile 2016

7

MENTAL HEALTH

Older South Carolinians 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 

South Carolinians in the 50‒64 age 

group experience FMD at a rate lower 

than the regional rate and higher than 

the national rate, while those in the 65+ 

age group experience it at a rate equal 

to the regional rate and higher than the 

national rate. 

12.2%

13.3%

8.1%

12.9%

14.7%

8.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18 to 49 50 to 64 65+

South Carolina Region 4 U.S.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in South Carolina, Region 4, and the United States, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older South Carolinians Reporting Frequent Mental Distress by Age Group 

and Sex

Older men in South Carolina 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, 

14.5 percent of women in the 50–64 age 

group and 9.9 percent in the 65+ age 

group reported FMD, while 11.9 percent 

of men in the 50–64 age group and 

5.8 percent in the 65+ age group 

reported FMD.

10.0%

14.4%

11.9%

14.5%

5.8%

9.9%

0%

2%

4%

6%

8%

10%

12%

14%

16%

Male Female

18 to 49 50 to 64 65+

Exhibit 13. South Carolinians Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

South Carolina South Carolina 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 South Carolinians.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 9.3% 7.5% 12.0%

Dissatisfied or very 

dissatisfied 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.

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 South Carolina South Carolina 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.

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

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older South Carolinians Admitted to State Mental Health Services

Approximately 4.1 percent of the people served by the South Carolina mental health system were ages 65 

and older. This represents more than 3,320 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014
10 South Carolina South Carolina 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

Tennessee
 
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

TENNESSEE’S POPULATION

Tennessee Population by Age Group

Tennessee is home to 6,549,352 people. 

Of these:

• 2,292,873 (35.0 percent) are over age 50.

• 1,381,042 (21.1 percent) are over age 60.

• 645,458 (9.9 percent) are over age 70.

• 228,199 (3.5 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 

Tennesseans is as follows:

Race/Ethnicity of Tennesseans 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

84.6% 0.3% 13.2% 1.1% 0.0% 0.7% 1.7%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

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

Exhibit 1. Tennessee Population by Age Group, 2014

417 430 449

411 427 439

348

189

83

401 412

449

421 439

473

387

228

145

0

100

200

300

400

500

600

700

800

900

1,000

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

Male Female

Population in 1,000s

Source: U.S. Census Bureau, 2015

The Number of Older Tennesseans Is Growing

The proportion of Tennessee’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 

19.2 percent of Tennessee’s population 

will be 65 and older by the year 2030, 

an increase of 46.3 percent from 2015.

Projected Population in Tennessee

Age Group 2015 2025 2030

Under 18 23.7% 23.9% 24.3%

18 to 44 35.0% 34.0% 33.8%

45 to 64 26.4% 24.0% 22.7%

65+ 14.9% 18.1% 19.2%

Source: U.S. Census Bureau, 2005 0

500

1,000

1,500

2,000

2,500

3,000

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

Exhibit 2. Tennessee Population by Age Group, 2000–

2030

Population in 1,000s

August 2016

Tennessee
2

Tennessee Tennessee Profile 2016

SUICIDE AMONG OLDER TENNESSEANS

Tennessee Suicide Rate Compared With Regional and National Rates

The suicide rate among Tennesseans 

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 21.5 per 100,000 

people (7.1 for women and 38.4 for men). 

The rate among those ages 50–64 was 

higher than both the rate in the region 

(including Alabama, Florida, Georgia, 

Kentucky, Mississippi, North Carolina, 

and South Carolina) and the rate in the 

United States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

15.9

12.9

23.2

19.3

14.2

11.4

20.8

18.1

13.0

10.6

19.0

16.1

0

5

10

15

20

25

All Under 50 50 to 64 65+

Suicide Rate per 100,000 Population

Tennessee Region 4 U.S.

Exhibit 3. Suicide Rates in Tennessee, Region 4, 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 Tennessee

The suicide rate among Tennesseans 

ages 50+ fluctuated from a low of 

16.7 per 100,000 in 2004 to a high of 

21.5 per 100,000 in 2012 and 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.

0

5

10

15

20

25

30

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Exhibit 4. Trends in Suicide Rates in Tennessee by Age 

Group, 2004–2013

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 Tennessee Tennessee Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER TENNESSEANS

30-Day Binge Drinking Among Older Tennesseans

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, 

6.2 percent of Tennessee men ages 50–64 

reported binge drinking in the past 30 

days, while 3.3 percent of those in the 65+ 

group reported similar behavior. 

19.5%

6.2% 

3.3%

10.3%

3.5% 1.1%

0%

5%

10%

15%

20%

25%

18 to 49 50 to 64 65+

Male Female

Exhibit 5. Binge Drinking Rates in Tennessee by Age 

Group and Sex, 2013

Proportion of Population Engaging in Binge Drinking

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 

Tennessee 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). 0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

Proportion Using in Past Month

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.
4

Tennessee Tennessee Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Tennesseans

In 2012, there were 1,370 admissions 

of Tennesseans ages 50 and older to 

substance use disorder (SUD) treatment 

in state-funded treatment programs, 

a rate of 59.8 per 100,000 people ages 

50+. This rate was lower than the 

regional rate and the national average. 

Men made up 73.1 percent of these 

admissions. Of all admissions, 

62.1 percent were White/Caucasian, 

36.2 percent were Black/African 

American, and 22.5 percent were 

Hispanic. 

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

40.9% 35.2% 23.9%

94.5

212.4

383.2

29.9

78.6

120.3

0

50

100

150

200

250

300

350

400

450

Tennessee Region 4 U.S.

Male Female

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Tennessee, Region 4, and the United States by Sex, 2012

SUD Admission Rate per 100,000 Population

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 Tennesseans Ages 50+ by Insurance Type 

In Tennessee, 90.0 percent of older adult 

admissions to SUD treatment were 

uninsured, 2.8 percent had Medicaid, 6.2 

percent had Medicare, and 1.0 percent 

had private insurance.

SUD Treatment Admissions Among 

Tennesseans 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.

1.0% 2.8% 6.2%

90.0%

6.8%

11.2% 10.0%

72.1%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Private Medicaid Medicare None

Tennessee Region 4 U.S.

Exhibit 8. SUD Treatment Admissions of Adults Ages 

50+ in Tennessee, Region 4, and the United States by 

Insurance Type, 2012

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

Source: TEDS, 2012

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

5

Alcohol Use Disorder Treatment Admissions Among Tennesseans Ages 50+

Alcohol was the most frequently cited 

substance used by older Tennesseans 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 62.1 percent of admissions 

among those ages 50+. This was lower 

than the regional rate and equal to the 

national rate. 62.1% 63.9% 62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Tennessee Region 4 U.S.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Tennessee, Region 4, and the United States, 

2012

Proportion of Treatment Admissions 50+ With Primary Alcohol Use Disorder

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 37.9 percent of older adult 

admissions to publicly funded 

37.9% treatment in Tennessee. 36.1%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Tennessee Region 4 U.S.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Tennessee, Region 4, 

and the United States, 2012

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

Tennessee Tennessee 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 Tennesseans 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 

Tennesseans 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.

42.4%

27.1%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Tennessee Region 4 U.S.

Proportion of Treatment Admissions 50+ With a Co-Occurring Disorder

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Tennessee, Region 4, 

and the United States, 2012

Source: TEDS, 2012

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

7

MENTAL HEALTH

Older Tennesseans 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 

Tennesseans in the 50‒64 age group 

experience FMD at a rate higher than the 

regional and national rates, while those 

in the 65+ age group experience it at 

a rate lower than the regional rate and 

roughly similar to the national rate.

12.3%

15.6%

7.3%

12.9%

14.7%

8.1%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

18 to 49 50 to 64 65+

Tennessee Region 4 U.S.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Tennessee, Region 4, and the United States, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Tennesseans Reporting Frequent Mental Distress by Age Group and Sex

Older men in Tennessee 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, 

17.5 percent of women in the 50–64 age 

group and 9.3 percent in the 65+ age 

group reported FMD, while 13.5 percent 

of men in the 50–64 age group and 

4.8 percent in the 65+ age group 

reported FMD. 8.2%

16.4%

13.5%

17.5%

4.8%

9.3%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

Male Female

18 to 49 50 to 64 65+

Exhibit 13. Tennesseans Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Tennessee Tennessee 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 Tennesseans.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 7.5% 7.6% 7.4%

Dissatisfied or very 

dissatisfied 4.9% 6.5% 2.6%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical 

health.

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 Tennessee Tennessee 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.

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

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older Tennesseans Admitted to State Mental Health Services

Approximately 1.7 percent of the people served by the Tennessee mental health system were ages 65 and 

older. This represents more than 4,260 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014
10 Tennessee Tennessee 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.