OLDER ADULTS BEHAVIORAL HEALTH PROFILES

REGION 7

MO

NE

KS

IA

IOWA

KANSAS

MISSOURI

NEBRASKA

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

Iowa
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

IOWA’S POPULATION

Iowa Population by Age Group

Iowa is home to 3,107,126 people. Of 

these:

• 1,116,700 (35.9 percent) are over age 50.

• 682,741 (22.0 percent) are over age 60.

• 341,647 (11.0 percent) are over age 70.

• 145,168 (4.7 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 63.4 percent of the 80+ group. 

The racial/ethnic composition of older 

Iowans is as follows:

Race/Ethnicity of Iowans 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

96.6% 0.3% 1.7% 1.0% 0.0% 0.4% 1.9%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

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

205 213 216

196 186

216

168

90

53

196 203 205

188 183

218

173

107

92

0

50

100

150

200

250

300

350

400

450

500

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

Exhibit 1. Iowa Population by Age Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older Iowans Is Growing

The proportion of Iowa’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 22.4 percent of Iowa’s 

population will be 65 and older by the 

year 2030, an increase of 34.1 percent 

from 2015.

Projected Population in Iowa

Age Group 2015 2025 2030

Under 18 23.4% 22.8% 22.4%

18 to 44 34.1% 32.2% 31.1%

45 to 64 26.2% 24.3% 24.0%

65+ 16.3% 20.7% 22.4%

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. Iowa Population by Age Group, 2000–2030

Population in 1,000s

August 2016

Iowa
2

Iowa Iowa Profile 2016

SUICIDE AMONG OLDER IOWANS

Iowa Suicide Rate Compared With Regional and National Rates

The suicide rate among Iowans 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 16.8 per 100,000 people (5.8 

for women and 29.1 for men). The rate 

among those ages 50–64 was lower than 

both the rate in the region (including 

Kansas, Missouri, and Nebraska) and the 

rate in the United States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

14.5

13.2

17.5

15.8

14.8

12.5

20.9

16.4

13.0

10.6

19.0

16.1

0

5

10

15

20

25

All Under 50 50 to 64 65+

Iowa Region 7 U.S.

Exhibit 3. Suicide Rates in Iowa, Region 7, 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 Iowa

The suicide rate among Iowans ages 

50+ fluctuated from a low of 11.6 per 

100,000 in 2005 to a high of 16.8 per 

100,000 in 2013. From 2004 to 2013, 

the rate was highest among those in 

the 50–64 age group.

How a state reports suicides can 

vary from year to year. The number 

of suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

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 Iowa 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 Iowa Iowa Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER IOWANS

30-Day Binge Drinking Among Older Iowans

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, 20.5 percent 

of Iowa men ages 50–64 reported binge 

drinking in the past 30 days, while 

6.6 percent of those in the 65+ group 

reported similar behavior.

40.0%

20.5% 

6.6%

22.8%

12.7%

2.1%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

18 to 49 50 to 64 65+

Male Female

Exhibit 5. Binge Drinking Rates in Iowa 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 Iowa 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

Iowa Iowa Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Iowans

In 2012, there were 3,065 admissions 

of Iowans ages 50 and older to 

substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 274.5 per 100,000 

people ages 50+. This rate was higher 

than the regional rate and the national 

average. Men made up 71.6 percent of 

these admissions. Of all admissions, 

88.6 percent were White/Caucasian 

8.2 percent were Black/African 

American, and 1.9 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

27.5% 44.7% 27.8%

416.7

450.9

383.2

147.4

117.1 120.3

0

50

100

150

200

250

300

350

400

450

500

Iowa Region 7 U.S.

Male Female

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Iowa, Region 7, 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 Iowans Ages 50+ by Insurance Type 

In Iowa, 54.4 percent of older 

adult admissions to SUD treatment 

were uninsured, 8.2 percent had 

Medicaid, 18.2 percent had Medicare, 

and 19.3 percent had private insurance.

SUD Treatment Admissions Among 

Iowans Ages 50+ by Primary Sources of 

Payment

Self-Pay Medicaid Other

36.4% 11.3% 52.2%

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. 19.3%

8.2%

18.2%

54.4%

7.4%

18.4%

10.3%

63.9%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

Private Medicaid Medicare None

Iowa Region 7 U.S.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Iowa, Region 7, 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 Iowa Iowa Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Iowans Ages 50+

Alcohol was the most frequently cited 

substance used by older Iowans in 

publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 73.0 percent of admissions 

among those ages 50+. This was 

higher than the regional and national 

rates.

73.0% 72.1%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Iowa Region 7 U.S.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Iowa, Region 7, 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 27.0 percent of older adult 

admissions to publicly funded 

treatment in Iowa.

27.0% 27.9%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Iowa Region 7 U.S.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Iowa, Region 7, 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

Iowa Iowa 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 Iowans 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 Iowans 

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.

47.6%

30.6%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Iowa Region 7 U.S.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Iowa, Region 7, 

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 Iowa Iowa Profile 2016

7

MENTAL HEALTH

Older Iowans 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 

Iowans experience FMD at a rate that 

is lower than the regional and national 

rates.

10.1%

9.4%

4.7%

11.6% 11.7%

5.9%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

Iowa Region 7 U.S.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Iowa, Region 7, and the United States, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Iowans Reporting Frequent Mental Distress by Age Group and Sex

Older men in Iowa 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, 

11.9 percent of women in the 50–64 age 

group and 5.4 percent in the 65+ age 

group reported FMD, while 6.8 percent 

of men in the 50–64 age group and 

3.8 percent in the 65+ age group 

reported FMD.

8.4%

12.0%

6.8%

11.9%

3.8%

5.4%

0%

2%

4%

6%

8%

10%

12%

14%

Male Female

18 to 49 50 to 64 65+

Exhibit 13. Iowans Reporting Frequent Mental Distress 

by Age Group and Sex, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Iowa Iowa 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 Iowans.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 7.4% 5.2% 10.2%

Dissatisfied or very 

dissatisfied 3.8% 4.6% 2.8%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical health.

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 Iowa Iowa 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 Iowans Admitted to State Mental Health Services

Approximately 2.8 percent of the people served by the Iowa mental health system were ages 65 and older. 

This represents more than 3,110 adults.

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

Kansas
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

KANSAS’ POPULATION

Kansas Population by Age Group

Kansas is home to 2,904,021 people. Of 

these:

• 976,223 (33.6 percent) are over age 50.

• 583,421 (20.1 percent) are over age 60.

• 284,118 (9.8 percent) are over age 70.

• 119,106 (4.1 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 62.5 percent of the 80+ group. 

The racial/ethnic composition of older 

Kansans is as follows:

Race/Ethnicity of Kansans 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

91.8% 0.8% 4.6% 1.7% 0.1% 1.0% 4.7%

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.

207 206 215

189

171

194

146

75

45

197 195 197

182

169

199

153

90

74

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+

Male Female

Population in 1,000s

Exhibit 1. Kansas Population by Age Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older Kansans Is Growing

The proportion of Kansas’ 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 20.2 percent of Kansas’ 

population will be 65 and older by the 

year 2030, an increase of 41.3 percent 

from 2015.

Projected Population in Kansas

Age Group 2015 2025 2030

Under 18 24.8% 24.4% 24.1%

18 to 44 35.1% 33.9% 33.3%

45 to 64 25.4% 23.0% 22.4%

65+ 14.7% 18.7% 20.2%

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. Kansas Population by Age Group, 2000–2030

Population in 1,000s

August 2016

Kansas
2

Kansas Kansas Profile 2016

SUICIDE AMONG OLDER KANSANS

Kansas Suicide Rate Compared With Regional and National Rates

The suicide rate among Kansans 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 21.3 per 100,000 people (8.6 

for women and 35.6 for men). The rate 

among those ages 50–64 was higher than 

both the rate in the region (including 

Iowa, Missouri, and Nebraska) and the 

rate in the United States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

14.7

11.4

24.9

16.3

14.8

12.5

20.9

16.4

13.0

10.6

19.0

16.1

0

5

10

15

20

25

30

All Under 50 50 to 64 65+

Kansas Region 7 U.S.

Exhibit 3. Suicide Rates in Kansas, Region 7, 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 Kansas

The suicide rate among Kansans ages 

50+ fluctuated from a low of 13.2 per 

100,000 in 2008 to a high of 21.5 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

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 Kansas 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 Kansas Kansas Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER KANSANS

30-Day Binge Drinking Among Older Kansans

Binge drinking, defined as five or more 

drinks for men and four or more drinks for 

women on a single occasion, can lead to 

serious health problems. Such problems 

include neurological damage, cardiovascular 

disease, liver disease, stroke, and poor 

control of diabetes. Binge drinkers are 

more likely to take risks such as driving 

while intoxicated and to experience falls 

and other accidents. Older people have a 

lower tolerance for alcohol. Binge drinking 

decreases with age and occurs more 

frequently among men than it does among 

women. As Exhibit 5 shows, 15.8 percent 

of Kansas men ages 50–64 reported 

binge drinking in the past 30 days, while 

4.9 percent of those in the 65+ group 

reported similar behavior. 

29.6%

15.8% 

4.9%

13.6%

7.2%

1.6% 0%

5%

10%

15%

20%

25%

30%

35%

18 to 49 50 to 64 65+

Male Female

Exhibit 5. Binge Drinking Rates in Kansas 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 statespecific data are not available, the 

Kansas 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

Kansas Kansas Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Kansans

In 2012, there were 1,364 admissions of 

Kansans ages 50 and older to substance 

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

139.7 per 100,000 people ages 50+. This 

rate was lower than the regional rate 

and the national average. Men made 

up 69.9 percent of these admissions. Of 

all admissions, 74.9 percent were White/

Caucasian, 19.1 percent were Black/

African American, and 5.2 percent 

were Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

29.5% 38.3% 32.2%

207.7

450.9

383.2

79.3

117.1 120.3

0

50

100

150

200

250

300

350

400

450

500

Kansas Region 7 U.S.

Male Female

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Kansas, Region 7, 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 Kansans Ages 50+ by Insurance Type 

In Kansas, 74.6 percent of older 

adult admissions to SUD treatment 

were uninsured, 20.2 percent had 

Medicaid, 0.7 percent had Medicare, 

and 4.5 percent had private insurance.

SUD Treatment Admissions Among 

Kansans Ages 50+ by Primary Sources 

of Payment

Self-Pay Medicaid Other

12.8% 20.2% 67.0%

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.

4.5%

20.2%

0.7%

74.6%

7.4%

18.4%

10.3%

63.9%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

Kansas Region 7 U.S.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Kansas, Region 7, 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 Kansas Kansas Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Kansans Ages 50+

Alcohol was the most frequently cited 

substance used by older Kansans in 

publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 65.5 percent of admissions 

among those ages 50+. This was lower 

than the regional rate and higher than 

the national rate.

65.5%

72.1%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Kansas Region 7 U.S.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Kansas, Region 7, 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 34.5 percent of older 

adult admissions to publicly funded 

treatment in Kansas.

34.5%

27.9%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Kansas Region 7 U.S.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Kansas, Region 7, 

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

Kansas Kansas 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 Kansans 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 Kansans 

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.

38.3%

30.6%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Kansas Region 7 U.S.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Kansas, Region 7, 

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 Kansas Kansas Profile 2016

7

MENTAL HEALTH

Older Kansans 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 

Kansans experience FMD at a rate that 

is lower than the regional and national 

rates.

10.7% 10.4%

5.7%

11.6% 11.7%

5.9%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

Kansas Region 7 U.S.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Kansas, Region 7, and the United States, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Kansans Reporting Frequent Mental Distress by Age Group and Sex

Older men in Kansas 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, 

11.8 percent of women in the 50–64 age 

group and 6.4 percent in the 65+ age 

group reported FMD, while 8.9 percent 

of men in the 50–64 age group and 

4.9 percent in the 65+ age group 

reported FMD.

8.6%

13.0%

8.9%

11.8%

4.9%

6.4%

0%

2%

4%

6%

8%

10%

12%

14%

Male Female

18 to 49 50 to 64 65+

Exhibit 13. Kansans Reporting Frequent Mental Distress 

by Age Group and Sex, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Kansas Kansas 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 Kansans.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 6.3% 4.9% 8.5%

Dissatisfied or very 

dissatisfied 3.9% 4.9% 2.4%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical health.

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 Kansas Kansas 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 Kansans Admitted to State Mental Health Services

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

older. This represents more than 6,140 adults.

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

Missouri
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

MISSOURI’S POPULATION

Missouri Population by Age Group

Missouri is home to 6,063,589 people. Of 

these:

• 2,163,870 (35.7 percent) are over age 50.

• 1,297,985 (21.4 percent) are over age 60.

• 632,091 (10.4 percent) are over age 70.

• 244,450 (4.0 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 62.9 percent of the 80+ group. 

The racial/ethnic composition of older 

Missourians is as follows:

Race/Ethnicity of Missourians 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

88.4% 0.5% 9.1% 1.2% 0.1% 0.9% 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.

391 403 421

381 370

424

316

176

91

373 384

415

383 378

442

350

212

154

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

Exhibit 1. Missouri Population by Age Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older Missourians Is Growing

The proportion of Missouri’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 20.2 percent of Missouri’s 

population will be 65 and older by the 

year 2030, an increase of 41.1 percent 

from 2015.

Projected Population in Missouri

Age Group 2015 2025 2030

Under 18 23.7% 23.4% 23.3%

18 to 44 35.0% 34.3% 33.7%

45 to 64 26.2% 23.5% 22.8%

65+ 15.2% 18.8% 20.2%

Source: U.S. Census Bureau, 2005

0

500

1,000

1,500

2,000

2,500

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

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

Population in 1,000s

August 2016

Missouri
2

Missouri Missouri Profile 2016

SUICIDE AMONG OLDER MISSOURIANS

Missouri Suicide Rate Compared With Regional and National Rates

The suicide rate among Missourians 

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 19.7 per 100,000 people (5.2 

for women and 36.4 for men). The rate 

among those ages 50–64 was higher than 

both the rate in the region (including 

Iowa, Kansas, and Nebraska) 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

13.8

21.4

17.4

14.8

12.5

20.9

16.4

13.0

10.6

19.0

16.1

0

5

10

15

20

25

All Under 50 50 to 64 65+

Missouri Region 7 U.S.

Exhibit 3. Suicide Rates in Missouri, Region 7, 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 Missouri

The suicide rate among Missourians 

ages 50+ fluctuated from a low of 

14.8 per 100,000 in 2004 and 2005 to 

a high of 19.7 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 Missouri 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 Missouri Missouri Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER MISSOURIANS

30-Day Binge Drinking Among Older Missourians

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, 19.3 percent 

of Missouri men ages 50–64 reported 

binge drinking in the past 30 days, while 

8.7 percent of those in the 65+ group 

reported similar behavior. 

30.5%

19.3% 

8.7%

17.4%

8.0%

1.2%

0%

5%

10%

15%

20%

25%

30%

35%

18 to 49 50 to 64 65+

Male Female

Exhibit 5. Binge Drinking Rates in Missouri 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 statespecific data are not available, the 

Missouri 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

Missouri Missouri Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Missourians

In 2012, there were 5,784 admissions 

of Missourians ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 267.3 per 100,000 

people ages 50+. This rate was lower 

than the regional rate and higher than 

the national average. Men made up 

78.6 percent of these admissions. Of all 

admissions, 67.2 percent were White/

Caucasian, 29.7 percent were Black/

African American, and 1.2 percent 

were Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

44.4% 43.8% 11.8%

451.6 450.9

383.2

106.9 117.1 120.3

0

50

100

150

200

250

300

350

400

450

500

Missouri Region 7 U.S.

Male Female

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Missouri, Region 7, 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 Missourians Ages 50+ by Insurance Type 

In Missouri, 62.5 percent of older 

adult admissions to SUD treatment 

were uninsured, 25.4 percent had 

Medicaid, 7.2 percent had Medicare, 

and 4.9 percent had private insurance.

SUD Treatment Admissions Among 

Missourians Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

21.5% 20.1% 58.4%

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.

4.9%

25.4%

7.2%

62.5%

7.4%

18.4%

10.3%

63.9%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

Private Medicaid Medicare None

Missouri Region 7 U.S.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Missouri, Region 7, 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 Missouri Missouri Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Missourians Ages 50+

Alcohol was the most frequently cited 

substance used by older Missourians 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 64.7 percent of admissions 

among those ages 50+. This was lower 

than the regional rate and higher than 

the national rate.

64.7%

72.1%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Missouri Region 7 U.S.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Missouri, Region 7, 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 35.3 percent of older adult 

admissions to publicly funded 

treatment in Missouri.

35.3%

27.9%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Missouri Region 7 U.S.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Missouri, Region 7, 

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

Missouri Missouri 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 Missourians 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 

Missourians ages 50+ with a cooccurring mental disorder. This rate is 

higher than the regional rate and lower 

than the national average. However, 

state reporting practices are a factor 

in these results.

33.0%

30.6%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Missouri Region 7 U.S.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Missouri, Region 7, 

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 Missouri Missouri Profile 2016

7

MENTAL HEALTH

Older Missourians 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 

Missourians in the 50–64 age group 

experience FMD at a rate that is higher 

than the regional and national rates, 

while those in the 65+ age group 

experience it at a rate that is higher 

than the regional rate and lower than 

the national rate.

13.3%

14.4%

6.6%

11.6% 11.7%

5.9%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18 to 49 50 to 64 65+

Missouri Region 7 U.S.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Missouri, Region 7, and the United States, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Missourians Reporting Frequent Mental Distress by Age Group and Sex

Older men in Missouri 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, 

14.8 percent of women in the 50–64 age 

group and 7.8 percent in the 65+ age 

group reported FMD, while 13.9 percent 

of men in the 50–64 age group and 

5.0 percent in the 65+ age group 

reported FMD.

10.5%

16.1%

13.9%

14.8%

5.0%

7.8%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

Male Female

18 to 49 50 to 64 65+

Exhibit 13. Missourians Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Missouri Missouri 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 Missourians.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 8.1% 7.1% 9.6%

Dissatisfied or very 

dissatisfied 5.3% 6.9% 3.2%

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 Missouri Missouri 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 Missourians Admitted to State Mental Health Services

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

older. This represents more than 2,300 adults.

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

Nebraska
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

NEBRASKA’S POPULATION

Nebraska Population by Age Group

Nebraska is home to 1,881,503 people. 

Of these:

• 634,423 (33.7 percent) are over age 50.

• 380,707 (20.2 percent) are over age 60.

• 186,461 (9.9 percent) are over age 70.

• 78,726 (4.2 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 62.5 percent of the 80+ group. 

The racial/ethnic composition of older 

Nebraskans is as follows:

Race/Ethnicity of Nebraskans 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

94.4% 0.7% 3.2% 1.2% 0.1% 0.5% 3.8%

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.

135 131 135 124

112

126

95

49

30

128 126 127

119

109

127

100

58

49

0

50

100

150

200

250

300

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

Male Female

Population in 1,000s

Exhibit 1. Nebraska Population by Age Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older Nebraskans Is Growing

The proportion of Nebraska’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 

20.6 percent of Nebraska’s population 

will be 65 and older by the year 2030, 

an increase of 38.5 percent from 2015.

Projected Population in Nebraska

Age Group 2015 2025 2030

Under 18 25.4% 25.2% 25.1%

18 to 44 34.0% 32.9% 32.5%

45 to 64 25.4% 22.7% 21.8%

65+ 15.2% 19.2% 20.6%

Source: U.S. Census Bureau, 2005

0

100

200

300

400

500

600

700

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

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

Population in 1,000s

August 2016

Nebraska
2

Nebraska Nebraska Profile 2016

SUICIDE AMONG OLDER NEBRASKANS

Nebraska Suicide Rate Compared With Regional and National Rates

The suicide rate among Nebraskans 

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 16.8 per 100,000 people (7.0 

for women and 27.8 for men). The rate 

among those ages 50–64 was lower than 

both the rate in the region (including 

Iowa, Kansas, and Missouri) and the rate 

in the United States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

11.8

9.3

18.8

14.0 14.8

12.5

20.9

16.4

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 

Nebraska Region 7 U.S.

Exhibit 3. Suicide Rates in Nebraska, Region 7, 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 Nebraska

The suicide rate among Nebraskans 

ages 50+ fluctuated from a low of 

10.6 per 100,000 in 2004 and 2005 to 

a high of 16.8 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

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 Nebraska 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 Nebraska Nebraska Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER NEBRASKANS

30-Day Binge Drinking Among Older Nebraskans

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, 19.6 percent 

of Nebraska men ages 50–64 reported 

binge drinking in the past 30 days, while 

6.4 percent of those in the 65+ group 

reported similar behavior. 

33.9%

19.6% 

6.4%

22.5%

10.5%

2.2% 0%

5%

10%

15%

20%

25%

30%

35%

40%

18 to 49 50 to 64 65+

Male Female

Exhibit 5. Binge Drinking Rates in Nebraska 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 statespecific data are not available, the 

Nebraska 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

Nebraska Nebraska Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Nebraskans

In 2012, there were 3,171 admissions 

of Nebraskans ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 499.8 per 100,000 

people ages 50+. This rate was higher 

than the regional rate and the national 

average. Men made up 83.4 percent 

of these admissions. Of all admissions, 

76.4 percent were White/Caucasian, 

14.1 percent were Black/African 

American, and 3.7 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

29.8% 56.0% 14.2%

881.5

450.9

383.2

157.6

117.1 120.3

0

100

200

300

400

500

600

700

800

900

1,000

Nebraska Region 7 U.S.

Male Female

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Nebraska, Region 7, 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 Nebraskans Ages 50+ by Insurance Type 

In Nebraska, 71.0 percent of older 

adult admissions to SUD treatment 

were uninsured, 14.6 percent had 

Medicaid, 12.4 percent had Medicare, 

and 2.0 percent had private insurance.

SUD Treatment Admissions Among 

Nebraskans Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

5.1% 4.4% 90.5%

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.

2.0%

14.6%

12.4%

71.0%

7.4%

18.4%

10.3%

63.9%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

Nebraska Region 7 U.S.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Nebraska, Region 7, 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 Nebraska Nebraska Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Nebraskans Ages 50+

Alcohol was the most frequently cited 

substance used by older Nebraskans 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 87.4 percent of admissions 

among those ages 50+. This was 

higher than the regional and national 

rates.

87.4%

72.1%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Nebraska Region 7 U.S.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Nebraska, Region 7, 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 12.6 percent of older adult 

admissions to publicly funded 

treatment in Nebraska.

12.6%

27.9%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Nebraska Region 7 U.S.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Nebraska, Region 7, 

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

Nebraska Nebraska 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 Nebraskans 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 

Nebraskans 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.

6.5%

30.6%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Nebraska Region 7 U.S.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Nebraska, Region 7, 

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 Nebraska Nebraska Profile 2016

7

MENTAL HEALTH

Older Nebraskans 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 

Nebraskans experience FMD at a rate 

that is lower than the regional and 

national rates.

10.0%

8.8%

5.6%

11.6% 11.7%

5.9%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

Nebraska Region 7 U.S.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Nebraska, Region 7, and the United States, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Nebraskans Reporting Frequent Mental Distress by Age Group and Sex

Older men in Nebraska 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, 

10.8 percent of women in the 50–64 age 

group and 6.4 percent in the 65+ age 

group reported FMD, while 6.9 percent 

of men in the 50–64 age group and 

4.6 percent in the 65+ age group 

reported FMD.

7.5%

12.6%

6.9%

10.8%

4.6%

6.4%

0%

2%

4%

6%

8%

10%

12%

14%

Male Female

18 to 49 50 to 64 65+

Exhibit 13. Nebraskans Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Nebraska Nebraska 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 Nebraskans.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 9.7% 6.5% 13.9%

Dissatisfied or very 

dissatisfied 3.8% 4.3% 3.2%

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 Nebraska Nebraska 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 Nebraskans Admitted to State Mental Health Services

Approximately 2.4 percent of the people served by the Nebraska mental health system were ages 65 and 

older. This represents more than 530 adults.

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