OLDER ADULTS BEHAVIORAL HEALTH PROFILES

REGION 8

CO

MT

WY

ND

SD

UT

COLORADO

MONTANA

NORTH DAKOTA

SOUTH DAKOTA

UTAH

WYOMING

A Behavioral Health Resource

SAMHSA’s State Technical Assistance Contract 

August 2016
OLDER ADULTS BEHAVIORAL HEALTH PROFILES

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

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

OVERVIEW

The Substance Abuse and Mental Health Services Administration 

recognizes the importance of behavioral health for older adults and 

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

vital and growing population. Administrators need clear and concise 

information to plan, implement, and evaluate effective prevention and 

treatment efforts in their states. 

The Older Adults Behavioral Health Profiles help states and communities 

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

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

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

State and community administrators, planners, and providers can use 

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

experience to establish and implement policies that improve the 

health and future of our valued older citizens.

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

Colorado
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

COLORADO’S POPULATION

Colorado Population by Age Group

Colorado is home to 5,355,866 people. Of 

these:

• 1,721,823 (32.1 percent) are over age 50.

• 991,802 (18.5 percent) are over age 60.

• 433,786 (8.1 percent) are over age 70.

• 159,760 (3.0 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 61.3 percent of the 80+ group. 

The racial/ethnic composition of older 

Coloradans is as follows:

Race/Ethnicity of Coloradans 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

91.9% 1.1% 3.4% 2.4% 0.1% 1.1% 11.9%

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.

354 358

410 391 359 360

271

127

62

336 339

375 368

346 370

287

147

98

0

100

200

300

400

500

600

700

800

900

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. Colorado Population by Age Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older Coloradans Is Growing

The proportion of Colorado’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 

16.5 percent of Colorado’s population 

will be 65 and older by the year 2030, 

an increase of 52.4 percent from 2015.

Projected Population in Colorado

Age Group 2015 2025 2030

Under 18 24.9% 25.2% 25.3%

18 to 44 37.3% 36.8% 37.0%

45 to 64 25.3% 22.2% 21.2%

65+ 12.4% 15.7% 16.5%

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+

Population in 1,000s

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

August 2016

Colorado
2

Colorado Colorado Profile 2016

SUICIDE AMONG OLDER COLORADANS

Colorado Suicide Rate Compared With Regional and National Rates

The suicide rate among Coloradans 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 26.4 per 100,000 people 

(12.9 for women and 41.3 for men). The 

rate among those ages 50–64 was lower 

than the rate in the region (including 

Montana, North Dakota, South Dakota, 

Utah, and Wyoming) 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.

Exhibit 3. Suicide Rates in Colorado, Region 8, and the 

United States, 2013

19.1

15.7

28.7

22.7

19.7

17.0

29.1

20.7

13.0

10.6

19.0

16.1

0

5

10

15

20

25

30

35

All Under 50 50 to 64 65+

Colorado Region 8 U.S.

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 Colorado

The suicide rate among Coloradans 

ages 50+ fluctuated from a low of 

19.1 per 100,000 in 2006 to a high 

of 26.8 per 100,000 in 2012. From 

2004 to 2013, the rate was generally 

highest among those in the 50–64 

age group.

How a state reports suicides can 

vary from year to year. The number 

of suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

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

2004–2013

0

5

10

15

20

25

30

35

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Suicide Rate per 100,000 Population

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

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

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER COLORADANS

30-Day Binge Drinking Among Older Coloradans

Binge drinking, defined as five or more 

drinks for men and four or more drinks for 

women on a single occasion, can lead to 

serious health problems. Such problems 

include neurological damage, cardiovascular 

disease, liver disease, stroke, and poor 

control of diabetes. Binge drinkers are 

more likely to take risks such as driving 

while intoxicated and to experience falls 

and other accidents. Older people have a 

lower tolerance for alcohol. Binge drinking 

decreases with age and occurs more 

frequently among men than it does among 

women. As Exhibit 5 shows, 16.3 percent 

of Colorado men ages 50–64 reported 

binge drinking in the past 30 days, while 

6.6 percent of those in the 65+ group 

reported similar behavior. 

Exhibit 5. Binge Drinking Rates in Colorado by Age 

Group and Sex, 2013

31.2%

16.3% 

6.6%

19.4%

8.2%

3.1%

0%

5%

10%

15%

20%

25%

30%

35%

18 to 49 50 to 64 65+

Male Female

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 

Colorado Behavioral Health Barometer

is available for download from the 

Substance Abuse and Mental Health 

Services Administration (SAMHSA) 

website (www.samhsa.gov/data 

/population-data-nsduh 

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

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

Colorado Colorado Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Coloradans

In 2012, there were 18,213 admissions 

of Coloradans ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 1,057.8 per 100,000 

people ages 50+. This rate was higher 

than the regional rate and the national 

average. Men made up 82.0 percent 

of these admissions. Of all admissions, 

83.0 percent were White/Caucasian, 

10.8 percent were Black/African 

American, and 24.6 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

18.4% 27.4% 54.2%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Colorado, Region 8, and the United States by Sex, 2012

1,820.9

1,132.1

383.2 363.6

246.4

120.3 0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

Colorado Region 8 U.S.

Male Female

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 Coloradans Ages 50+ by Insurance Type 

In Colorado, 67.3 percent of older adult 

admissions to SUD treatment were 

uninsured, 3.5 percent had Medicaid, 

2.7 percent had Medicare, and 

26.4 percent had private insurance.

SUD Treatment Admissions Among 

Coloradans Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

32.8% 4.1% 63.1%

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.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Colorado, Region 8, and the United States by 

Insurance Type, 2012

26.4% 

3.5% 2.7% 

67.3% 

21.7% 

5.0% 6.5% 

66.8% 

14.9% 

20.4% 

10.8% 

53.9% 

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

Colorado Region 8 U.S.

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 Colorado Colorado Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Coloradans Ages 50+

Alcohol was the most frequently cited 

substance used by older Coloradans 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 88.8 percent of admissions 

among those ages 50+. This was 

higher than the regional and national 

rates.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Colorado, Region 8, and the United States, 

2012

88.8% 87.2%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Colorado Region 8 U.S.

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 11.2 percent of older adult 

admissions to publicly funded 

treatment in Colorado.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Colorado, Region 8, 

and the United States, 2012

11.2%

12.8%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Colorado Region 8 U.S.

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

Colorado Colorado 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 Coloradans 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 

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

is lower than the regional rate and 

the national average. However, state 

reporting practices are a factor in 

these results.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Colorado, Region 8, 

and the United States, 2012

22.2%

26.0%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Colorado Region 8 U.S.

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders

Source: TEDS, 2012

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

7

MENTAL HEALTH

Older Coloradans 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 

Coloradans experience FMD at a rate 

that is lower than the regional and 

national rates.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Colorado, Region 8, and the United States, 2013

10.8%

9.5%

5.6%

10.5% 10.2%

5.7%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

Colorado Region 8 U.S.

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Coloradans Reporting Frequent Mental Distress by Age Group and Sex

Older men in Colorado 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, 

11.3 percent of women in the 50–64 age 

group and 6.9 percent in the 65+ age 

group reported FMD, while 7.7 percent 

of men in the 50–64 age group and 

3.9 percent in the 65+ age group 

reported FMD.

Exhibit 13. Coloradans Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

8.5%

13.2%

7.7%

11.3%

3.9%

6.9%

0%

2%

4%

6%

8%

10%

12%

14%

Male Female

18 to 49 50 to 64 65+

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Colorado Colorado 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 Coloradans.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 7.6% 6.5% 9.6%

Dissatisfied or very 

dissatisfied 4.3% 4.9% 3.3%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical health.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 Colorado Colorado Profile 2016

9

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

High Blood Pressure, and Coronary Disease

Older Americans who experience FMD 

are more likely to report that they have 

health problems. People with FMD 

were more than twice as likely to report 

having a stroke than those with some 

or no mental distress. They experienced 

coronary disease and heart attack at 

more than 1.6 times, diabetes at more 

than 1.4 times, and high blood pressure 

at nearly 1.2 times the rate of those with 

some or no mental distress.

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

10.1%

13.3% 13.2%

25.9%

60.6%

4.7%

7.6% 7.8%

17.7%

51.1%

0%

10%

20%

30%

40%

50%

60%

70%

Stroke Coronary disease Heart attack Diabetes High blood pressure

Frequent mental distress Some or no mental distress

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older Coloradans Admitted to State Mental Health Services

Approximately 2.9 percent of the people served by the Colorado mental health system were ages 65 and 

older. This represents more than 3,330 adults.

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

Montana
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

MONTANA’S POPULATION

Montana Population by Age Group

Montana is home to 1,023,579 people. Of 

these:

• 393,962 (38.5 percent) are over age 50.

• 243,992 (23.8 percent) are over age 60.

• 113,167 (11.1 percent) are over age 70.

• 42,389 (4.1 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 59.5 percent of the 80+ group. 

The racial/ethnic composition of older 

Montanans is as follows:

Race/Ethnicity of Montanans 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

94.2% 3.8% 0.2% 0.5% 0.1% 1.2% 1.5%

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. Montana Population by Age Group, 2014

64 65

72

64 58

73

66

35

17

61 61

67

61

57

76

65

36

25

0

20

40

60

80

100

120

140

160

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

Male Female

Population in 1,000s

Source: U.S. Census Bureau, 2015

The Number of Older Montanans Is Growing

The proportion of Montana’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 

25.8 percent of Montana’s population 

will be 65 and older by the year 2030, 

an increase of 55.1 percent from 2015.

Projected Population in Montana

Age Group 2015 2025 2030

Under 18 21.6% 20.8% 20.1%

18 to 44 32.6% 30.2% 28.4%

45 to 64 28.4% 25.2% 25.7%

65+ 17.4% 23.9% 25.8%

Source: U.S. Census Bureau, 2005

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

0

50

100

150

200

250

300

350

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

Population in 1,000s

August 2016

Montana
2

Montana Montana Profile 2016

SUICIDE AMONG OLDER MONTANANS

Montana Suicide Rate Compared With Regional and National Rates

The suicide rate among Montanans 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 26.5 per 100,000 people (10.0 

for women and 44.0 for men). The rate 

among those ages 50–64 was higher than 

both the rate in the region (including 

Colorado, North Dakota, South Dakota, 

Utah, and Wyoming) and the rate in the 

United States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in Montana, Region 8, and the 

United States, 2013

23.9

22.3

29.5

22.5

19.7

17.0

29.1

20.7

13.0

10.6

19.0

16.1

0

5

10

15

20

25

30

35

All Under 50 50 to 64 65+

Montana Region 8 U.S.

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 Montana

The suicide rate among Montanans 

ages 50+ fluctuated from a low of 

20.7 per 100,000 in 2004 to a high of 

29.9 per 100,000 in 2010. From 2004 

to 2013, the rate was generally highest 

among those in the 50–64 age group.

How a state reports suicides can 

vary from year to year. The number 

of suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

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

2004–2013

0

5

10

15

20

25

30

35

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Suicide Rate per 100,000 Population

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

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

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER MONTANANS

30-Day Binge Drinking Among Older Montanans

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, 23.7 percent 

of Montana 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. 

Exhibit 5. Binge Drinking Rates in Montana by Age 

Group and Sex, 2013

36.9%

23.7% 

7.4%

21.5%

11.5%

3.1%

0%

5%

10%

15%

20%

25%

30%

35%

40%

18 to 49 50 to 64 65+

Male Female

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 

Montana Behavioral Health Barometer

is available for download from the 

Substance Abuse and Mental Health 

Services Administration (SAMHSA) 

website (www.samhsa.gov/data 

/population-data-nsduh 

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

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

Montana Montana Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Montanans

In 2012, there were 1,160 admissions 

of Montanans ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 294.4 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, 

79.3 percent were White/Caucasian, 

0.4 percent were Black/African 

American, and 2.3 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

19.8% 58.6% 21.6%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Montana, Region 8, and the United States by Sex, 2012

459.3

1,132.1

383.2

139.1

246.4

120.3

0

200

400

600

800

1,000

1,200

Montana Region 8 U.S.

Male Female

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 Montanans Ages 50+ by Insurance Type 

In Montana, 70.5 percent of older 

adult admissions to SUD treatment 

were uninsured, 5.4 percent had 

Medicaid, 13.4 percent had Medicare, 

and 10.8 percent had private insurance.

SUD Treatment Admissions Among 

Montanans Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

25.9% 4.7% 69.3%

Self-pay data include private insurance.

Exhibit 8 and the accompanying text reflect the type of 

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

above represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Montana, Region 8, and the United States by 

Insurance Type, 2012

10.8%

5.4%

13.4%

70.5%

21.7%

5.0% 6.5%

66.8%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

Montana Region 8 U.S.

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 Montana Montana Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Montanans Ages 50+

Alcohol was the most frequently cited 

substance used by older Montanans 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 84.3 percent of admissions 

among those ages 50+. This was lower 

than the regional rate and higher than 

the national rate.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Montana, Region 8, and the United States, 

2012

84.3% 87.2%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Montana Region 8 U.S.

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 15.7 percent of older adult 

admissions to publicly funded 

treatment in Montana.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Montana, Region 8, 

and the United States, 2012

15.7%

12.8%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Montana Region 8 U.S.

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

Montana Montana 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 Montanans 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 

Montanans 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.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Montana, Region 8, 

and the United States, 2012

30.3%

26.0%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Montana Region 8 U.S.

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders

Source: TEDS, 2012

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

7

MENTAL HEALTH

Older Montanans 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 

Montanans experience FMD at a rate 

that is higher than the regional rate and 

lower than the national rate.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Montana, Region 8, and the United States, 2013

10.3%

12.5%

6.2%

10.5% 10.2%

5.7%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

Montana Region 8 U.S.

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Montanans Reporting Frequent Mental Distress by Age Group and Sex

Older men in Montana were more likely 

to indulge in binge drinking, but older 

women were more likely to report that 

they had FMD (14 days or more per 

30-day period). As Exhibit 13 shows, 

14.1 percent of women in the 50–64 age 

group and 7.8 percent in the 65+ age 

group reported FMD, while 10.1 percent 

of men in the 50–64 age group and 

6.1 percent in the 65+ age group 

reported FMD.

Exhibit 13. Montanans Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

9.1%

11.6%

10.1%

14.8%

6.1% 6.2%

0%

2%

4%

6%

8%

10%

12%

14%

16%

Male Female

18 to 49 50 to 64 65+

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Montana Montana 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 Montanans.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 9.7% 7.6% 12.9%

Dissatisfied or very 

dissatisfied 4.9% 5.6% 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.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 Montana Montana Profile 2016

9

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

High Blood Pressure, and Coronary Disease

Older Americans who experience FMD 

are more likely to report that they have 

health problems. People with FMD 

were more than twice as likely to report 

having a stroke than those with some 

or no mental distress. They experienced 

coronary disease and heart attack at 

more than 1.6 times, diabetes at more 

than 1.4 times, and high blood pressure 

at nearly 1.2 times the rate of those with 

some or no mental distress.

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

10.1%

13.3% 13.2%

25.9%

60.6%

4.7%

7.6% 7.8%

17.7%

51.1%

0%

10%

20%

30%

40%

50%

60%

70%

Stroke Coronary disease Heart attack Diabetes High blood pressure

Frequent mental distress Some or no mental distress

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older Montanans Admitted to State Mental Health Services

Approximately 6.3 percent of the people served by the Montana mental health system were ages 65 and 

older. This represents more than 2,500 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014
10 Montana Montana 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 Dakota
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

NORTH DAKOTA’S POPULATION

North Dakota Population by Age Group

North Dakota is home to 739,482 people. 

Of these:

• 246,452 (33.3 percent) are over age 50.

• 147,462 (19.9 percent) are over age 60.

• 73,416 (9.9 percent) are over age 70.

• 32,755 (4.4 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 

North Dakotans is as follows:

Race/Ethnicity of North Dakotans 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

95.1% 3.0% 0.7% 0.6% 0.0% 0.6% 0.9%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

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

Exhibit 1. North Dakota Population by Age Group, 

2014

51 48

69

50

41

50

38

19

12

48

45

58

44

39

49

36

22

21

0

20

40

60

80

100

120

140

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 North Dakotans Is Growing

The proportion of North Dakota’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 

25.1 percent of North Dakota’s 

population will be 65 and older by the 

year 2030, an increase of 41.2 percent 

from 2015.

Projected Population in North Dakota

Age Group 2015 2025 2030

Under 18 21.8% 21.6% 21.2%

18 to 44 34.5% 32.1% 31.0%

45 to 64 26.7% 23.4% 22.7%

65+ 17.0% 22.9% 25.1%

Source: U.S. Census Bureau, 2005

Exhibit 2. North Dakota Population by Age Group, 

2000–2030

0

50

100

150

200

250

300

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

Population in 1,000s

August 2016

North Dakota
2

North Dakota North Dakota Profile 2016

SUICIDE AMONG OLDER ADULTS IN REGION 8

Region 8 Suicide Rates Compared With National Rates

Suicide data for North Dakotans of 

various ages were unavailable for 

2013. Therefore, the rates for Region 8 

(including Colorado, Montana, South 

Dakota, Utah, and Wyoming) are used 

instead.

The suicide rate among individuals ages 

50+ in Region 8 was higher than the rate 

among younger age groups. In 2013, 

the total suicide rate among all people 

ages 50+ was 25.7 per 100,000 people 

(10.8 for women and 41.9 for men). The 

rate among those ages 50–64 was higher 

than the rate in the United States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in Region 8 and the United 

States, 2013

19.7

17.0

29.1

20.7

13.0

10.6

19.0

16.1

0

5

10

15

20

25

30

35

All Under 50 50 to 64 65+

Suicide Rate per 100,000 Population 

Region 8 U.S.

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

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

WONDER Online Database, released 2015

Trends in Suicide Rates in Region 8

Suicide data for North Dakotans 

of various ages were unavailable. 

Therefore, the rates for Region 8 are 

used instead.

The suicide rate among individuals in 

Region 8 ages 50+ fluctuated from 

a low of 20.5 per 100,000 in 2004 to 

a high of 25.8 per 100,000 in 2012. 

From 2004 to 2013, the rate was 

generally highest among those in 

the 50–64 age group.

How a state reports suicides can 

vary from year to year. The number 

of suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

Exhibit 4. Trends in Suicide Rates in Region 8 by Age Group, 

2004–2013

0

5

10

15

20

25

30

35

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Suicide Rate per 100,000 Population

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

Online Database, released 2015
Alabama ALABAMA Profile 2015 North Dakota North Dakota Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER NORTH DAKOTANS

30-Day Binge Drinking Among Older North Dakotans

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, 24.0 percent 

of North Dakota men ages 50–64 reported 

binge drinking in the past 30 days, while 

8.5 percent of those in the 65+ group 

reported similar behavior. 

Exhibit 5. Binge Drinking Rates in North Dakota by Age 

Group and Sex, 2013

43.2%

24.0% 

8.5%

24.8%

9.2%

1.4%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

18 to 49 50 to 64 65+

Male Female

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 Dakota Behavioral Health 

Barometer is available for download 

from the Substance Abuse and 

Mental Health Services Administration 

(SAMHSA) website (www.samhsa.gov 

/data/population-data-nsduh 

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

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 Dakota North Dakota Profile 2016

Admissions to Substance Use Disorder Treatment Among Older North Dakotans

In 2012, there were 286 admissions 

of North Dakotans ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 116.0 per 100,000 

people ages 50+. This rate was lower 

than the regional rate and the national 

average. Men made up 64.7 percent 

of these admissions. Of all admissions, 

83.9 percent were White/Caucasian, 

1.4 percent were Black/African 

American, and 1.4 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

25.9% 36.4% 37.8%

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

North Dakota, Region 8, and the United States by Sex, 2012

155.1

1,132.1

383.2

79.4

246.4

120.3

0

200

400

600

800

1,000

1,200

North Dakota Region 8 U.S.

Male Female

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 Dakotans Ages 50+ by Insurance Type 

In North Dakota, 57.2 percent of older 

adult admissions to SUD treatment 

were uninsured, 10.4 percent had 

Medicaid, 20.1 percent had Medicare, 

and 12.2 percent had private insurance.

SUD Treatment Admissions Among 

North Dakotans Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

48.5% 10.6% 40.9%

Self-pay data include private insurance.

Exhibit 8 and the accompanying text reflect the type of 

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

above represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in North Dakota, Region 8, and the United States by 

Insurance Type, 2012

12.2% 10.4%

20.1%

57.2%

21.7%

5.0% 6.5%

66.8%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

North Dakota Region 8 U.S.

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 North Dakota North Dakota Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among North Dakotans Ages 50+

Alcohol was the most frequently 

cited substance used by older North 

Dakotans in publicly financed SUD 

treatment in 2012. It was mentioned 

as a substance of use in 85.3 percent 

of admissions among those ages 50+. 

This was lower than the regional and 

national rates.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in North Dakota, Region 8, and the United 

States, 2012

85.3% 87.2%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

North Dakota Region 8 U.S.

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 14.7 percent of older adult 

admissions to publicly funded 

treatment in North Dakota.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in North Dakota, 

Region 8, and the United States, 2012

14.7%

12.8%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

North Dakota Region 8 U.S.

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

North Dakota North Dakota 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 Dakotans 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 Dakotans ages 50+ with a 

co-occurring mental disorder. This 

rate is higher than the regional rate 

and the national average. However, 

state reporting practices are a factor 

in these results.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in North Dakota, 

Region 8, and the United States, 2012

46.9%

26.0%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

North Dakota Region 8 U.S.

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders

Source: TEDS, 2012

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

7

MENTAL HEALTH

Older North Dakotans 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 

North Dakotans experience FMD at a 

rate that is lower than the regional and 

national rates.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in North Dakota, Region 8, and the United States, 2013

7.8%

10.0%

4.7%

10.5% 10.2%

5.7%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

North Dakota Region 8 U.S.

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older North Dakotans Reporting Frequent Mental Distress by Age Group 

and Sex

Older men in North Dakota 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, 

10.1 percent of women in the 50–64 age 

group and 4.3 percent in the 65+ age 

group reported FMD, while 9.8 percent 

of men in the 50–64 age group and 

5.2 percent in the 65+ age group 

reported FMD.

Exhibit 13. North Dakotans Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

5.4%

10.5%

9.8% 10.1%

5.2%

4.3%

0%

2%

4%

6%

8%

10%

12%

Male Female

18 to 49 50 to 64 65+

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

North Dakota North Dakota 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 Dakotans.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 8.3% 5.3% 12.0%

Dissatisfied or very 

dissatisfied 3.6% 4.5% 2.5%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical health.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 North Dakota North Dakota Profile 2016

9

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

High Blood Pressure, and Coronary Disease

Older Americans who experience FMD 

are more likely to report that they have 

health problems. People with FMD 

were more than twice as likely to report 

having a stroke than those with some 

or no mental distress. They experienced 

coronary disease and heart attack at 

more than 1.6 times, diabetes at more 

than 1.4 times, and high blood pressure 

at nearly 1.2 times the rate of those with 

some or no mental distress.

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

10.1%

13.3% 13.2%

25.9%

60.6%

4.7%

7.6% 7.8%

17.7%

51.1%

0%

10%

20%

30%

40%

50%

60%

70%

Stroke Coronary disease Heart attack Diabetes High blood pressure

Frequent mental distress Some or no mental distress

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older North Dakotans Admitted to State Mental Health Services

Approximately 5.8 percent of the people served by the North Dakota mental health system were ages 65 

and older. This represents more than 990 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014
10 North Dakota North Dakota 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 Dakota
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

SOUTH DAKOTA’S POPULATION

South Dakota Population by Age Group

South Dakota is home to 853,175 people. 

Of these:

• 300,994 (35.3 percent) are over age 50.

• 183,250 (21.5 percent) are over age 60.

• 89,750 (10.5 percent) are over age 70.

• 38,666 (4.5 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 62.6 percent of the 80+ group. 

The racial/ethnic composition of older 

South Dakotans is as follows:

Race/Ethnicity of South Dakotans 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

93.2% 4.6% 0.8% 0.6% 0.0% 0.7% 1.3%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

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

Exhibit 1. South Dakota Population by Age Group, 

2014

62 58 61

54

49

59

47

24

14

59

55 56

51

47

59

46

27

24

0

20

40

60

80

100

120

140

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 South Dakotans Is Growing

The proportion of South Dakota’s 

population that is 65 and older is 

growing while the proportion that 

is younger than 65 is shrinking. The 

U.S. Census Bureau estimates that 

23.1 percent of South Dakota’s 

population will be 65 and older by the 

year 2030, an increase of 44.6 percent 

from 2015.

Projected Population in South Dakota

Age Group 2015 2025 2030

Under 18 24.6% 24.5% 24.5%

18 to 44 33.1% 30.9% 29.5%

45 to 64 26.2% 23.5% 22.9%

65+ 16.1% 21.2% 23.1%

Source: U.S. Census Bureau, 2005

Exhibit 2. South Dakota Population by Age Group, 

2000–2030

0

50

100

150

200

250

300

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

Population in 1,000s

August 2016

South Dakota
2

South Dakota South Dakota Profile 2016

SUICIDE AMONG OLDER SOUTH DAKOTANS

Region 8 Suicide Rates Compared With National Rates

Suicide data for South Dakotans of 

various ages were unavailable for 

2013. Therefore, the rates for Region 8 

(including Colorado, Montana, North 

Dakota, Utah, and Wyoming) are used 

instead.

The suicide rate among individuals ages 

50+ in Region 8 was higher than the rate 

among younger age groups. In 2013, the 

total suicide rate among all people ages 

50+ was 25.7 per 100,000 people (10.8 

for women and 41.9 for men). The rate 

among those ages 50–64 was higher than 

the rate in the United States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in Region 8 and the United 

States, 2013

19.7

17.0

29.1

20.7

13.0

10.6

19.0

16.1

0

5

10

15

20

25

30

35

All Under 50 50 to 64 65+

Suicide Rate per 100,000 Population 

Region 8 U.S.

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

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

WONDER Online Database, released 2015

Trends in Suicide Rates in Region 8

Suicide data for South Dakotans 

of various ages were unavailable. 

Therefore, the rates for Region 8 

are used instead.

The suicide rate among individuals in 

Region 8 ages 50+ fluctuated from 

a low of 20.5 per 100,000 in 2004 to 

a high of 25.8 per 100,000 in 2012. 

From 2004 to 2013, the rate was 

generally highest among those in 

the 50–64 age group.

How a state reports suicides can 

vary from year to year. The number 

of suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

Exhibit 4. Trends in Suicide Rates in Region 8 by Age Group, 

2004–2013

0

5

10

15

20

25

30

35

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Suicide Rate per 100,000 Population

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

Online Database, released 2015
Alabama ALABAMA Profile 2015 South Dakota South Dakota Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER SOUTH DAKOTANS

30-Day Binge Drinking Among Older South Dakotans

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, 17.0 percent 

of South Dakota men ages 50–64 reported 

binge drinking in the past 30 days, while 

4.2 percent of those in the 65+ group 

reported similar behavior. 

Exhibit 5. Binge Drinking Rates in South Dakota by Age 

Group and Sex, 2013

36.5%

17.0% 

4.2%

21.1%

10.4%

0.8%

0%

5%

10%

15%

20%

25%

30%

35%

40%

18 to 49 50 to 64 65+

Male Female

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 Dakota Behavioral Health 

Barometer is available for download 

from the Substance Abuse and 

Mental Health Services Administration 

(SAMHSA) website (www.samhsa.gov 

/data/population-data-nsduh 

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

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 Dakota South Dakota Profile 2016

Admissions to Substance Use Disorder Treatment Among Older South Dakotans

In 2012, there were 2,249 admissions 

of South Dakotans ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 747.2 per 100,000 

people ages 50+. This rate was higher 

than the regional rate and the national 

average. Men made up 78.0 percent 

of these admissions. Of all admissions, 

51.7 percent were White/Caucasian, 

1.5 percent were Black/African 

American, and 2.8 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

16.2% 56.3% 27.5%

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

South Dakota, Region 8, and the United States by Sex, 2012

1,214.3

1,132.1

383.2

315.7

246.4

120.3

0

200

400

600

800

1,000

1,200

1,400

South Dakota Region 8 U.S.

Male Female

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 Dakotans Ages 50+ by Insurance Type 

In South Dakota, 49.9 percent of older 

adult admissions to SUD treatment 

were uninsured, 11.4 percent had 

Medicaid, 29.6 percent had Medicare, 

and 9.1 percent had private insurance.

SUD Treatment Admissions Among 

South Dakotans Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

17.2% 0.2% 82.6%

Self-pay data include private insurance.

Exhibit 8 and the accompanying text reflect the type of 

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

above represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in South Dakota, Region 8, and the United States by 

Insurance Type, 2012

9.1%

11.4%

29.6%

49.9%

21.7%

5.0% 6.5%

66.8%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

South Dakota Region 8 U.S.

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 Dakota South Dakota Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among South Dakotans Ages 50+

Alcohol was the most frequently 

cited substance used by older South 

Dakotans in publicly financed SUD 

treatment in 2012. It was mentioned 

as a substance of use in 93.4 percent 

of admissions among those ages 50+. 

This was higher than the regional and 

national rates.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in South Dakota, Region 8, and the United 

States, 2012

er

100%

ol Use Disord

90% 93.4%

87.2%

80%

ohy Alc

70%

rimar s 50+ With P

60% 62.1%

50%

mission

40%

t Adtmen

30%

ear

20%

 of Ton

10%

ortioprP

0%

South Dakota Region 8 U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions for Non-Alcohol Substance Use

Substances other than alcohol were 

cited as the primary substances of 

use for 6.6 percent of older adult 

admissions to publicly funded 

treatment in South Dakota.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in South Dakota, 

Region 8, and the United States, 2012

6.6%

12.8%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

South Dakota Region 8 U.S.

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

South Dakota South Dakota 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 Dakotans 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 

Dakotans ages 50+ with a co-occurring 

mental disorder. This rate is higher 

than the regional rate and the national 

average. However, state reporting 

practices are a factor in these results.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in South Dakota, 

Region 8, and the United States, 2012

50.0%

26.0%

33.7%

0%

10%

20%

30%

40%

50%

60%

South Dakota Region 8 U.S.

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders

Source: TEDS, 2012

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

7

MENTAL HEALTH

Older South Dakotans 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 

South Dakotans experience FMD at a 

rate that is lower than the regional and 

national rates.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in South Dakota, Region 8, and the United States, 2013

9.0%

7.3%

4.9%

10.5% 10.2%

5.7%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

South Dakota Region 8 U.S.

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older South Dakotans Reporting Frequent Mental Distress by Age Group 

and Sex

Older men in South Dakota 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, 

10.2 percent of women in the 50–64 age 

group and 6.0 percent in the 65+ age 

group reported FMD, while 4.6 percent 

of men in the 50–64 age group and 

3.6 percent in the 65+ age group 

reported FMD.

Exhibit 13. South Dakotans Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

6.6%

11.6%

4.6%

10.2%

3.6%

6.0%

0%

2%

4%

6%

8%

10%

12%

14%

Male Female

18 to 49 50 to 64 65+

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

South Dakota South Dakota 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 Dakotans.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 8.1% 5.7% 11.4%

Dissatisfied or very 

dissatisfied 3.2% 3.3% 3.0%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor Physical 

Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical health.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 South Dakota South Dakota Profile 2016

9

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

High Blood Pressure, and Coronary Disease

Older Americans who experience FMD 

are more likely to report that they have 

health problems. People with FMD 

were more than twice as likely to report 

having a stroke than those with some 

or no mental distress. They experienced 

coronary disease and heart attack at 

more than 1.6 times, diabetes at more 

than 1.4 times, and high blood pressure 

at nearly 1.2 times the rate of those with 

some or no mental distress.

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

10.1%

13.3% 13.2%

25.9%

60.6%

4.7%

7.6% 7.8%

17.7%

51.1%

0%

10%

20%

30%

40%

50%

60%

70%

Stroke Coronary disease Heart attack Diabetes High blood pressure

Frequent mental distress Some or no mental distress

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older South Dakotans Admitted to State Mental Health Services

Approximately 5.6 percent of the people served by the South Dakota mental health system were ages 65 

and older. This represents more than 850 adults.

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

Utah
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

UTAH’S POPULATION

Utah Population by Age Group

Utah is home to 2,942,902 people. Of 

these:

• 727,541 (24.7 percent) are over age 50.

• 422,657 (14.4 percent) are over age 60.

• 195,595 (6.6 percent) are over age 70.

• 71,444 (2.4 percent) are ages 80 and

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 57.9 percent of the 80+ group. 

The racial/ethnic composition of older 

Utahns is as follows:

Race/Ethnicity of Utahns 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

94.6% 1.1% 0.8% 2.1% 0.6% 0.7% 7.3%

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. Utah Population by Age Group, 2014

264 243 234 223

166 151

111

58

30

250

233 228

214

161 154

117

66

41

0

100

200

300

400

500

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+

Male Female

Population in 1,000s

Source: U.S. Census Bureau, 2015

The Number of Older Utahns Is Growing

The proportion of Utah’s population 

that is 65 and older is growing while 

the proportion that is younger than 65 

is shrinking. The U.S. Census Bureau 

estimates that 13.2 percent of Utah’s 

population will be 65 and older by the 

year 2030, an increase of 63.9 percent 

from 2015.

Projected Population in Utah

Age Group 2015 2025 2030

Under 18 31.3% 30.4% 30.4%

18 to 44 38.6% 37.0% 36.9%

45 to 64 20.0% 20.0% 19.5%

65+ 10.1% 12.6% 13.2%

Source: U.S. Census Bureau, 2005

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

0

200

400

600

800

1,000

1,200

1,400

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

Population in 1,000s

August 2016

Utah
2

Utah Utah Profile 2016

SUICIDE AMONG OLDER UTAHNS

Utah Suicide Rate Compared With Regional and National Rates

The suicide rate among Utahns 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 29.9 per 100,000 people 

(13.0 for women and 48.2 for men). 

The rate among those ages 50–64 was 

higher than both the rate in the region 

(including Colorado, Montana, North 

Dakota, South Dakota, and Wyoming) 

and the rate in the United States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in Utah, Region 8, and the United 

States, 2013

20.0

16.7

34.8

22.6

19.7

17.0

29.1

20.7

13.0

10.6

19.0

16.1

0

5

10

15

20

25

30

35

40

All Under 50 50 to 64 65+

Suicide Rate per 100,000 Population 

Utah Region 8 U.S.

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

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

WONDER Online Database, released 2015

Trends in Suicide Rates in Utah

The suicide rate among Utahns ages 

50+ fluctuated from a low of 18.3 per 

100,000 in 2005 to a high of 29.9 per 

100,000 in 2013. From 2004 to 2013, 

the rate was highest among those in 

the 50–64 age group.

How a state reports suicides can 

vary from year to year. The number 

of suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

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

2004–2013

0

5

10

15

20

25

30

35

40

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Suicide Rate per 100,000 Population

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

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

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER UTAHNS

30-Day Binge Drinking Among Older Utahns

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, 

12.1 percent of Utah men ages 50–64 

reported binge drinking in the past 30 

days, while 4.4 percent of those in the 65+ 

group reported similar behavior. 

Exhibit 5. Binge Drinking Rates in Utah by Age Group 

and Sex, 2013

20.0%

12.1% 

4.4%

11.0%

6.6%

1.5% 0%

5%

10%

15%

20%

25%

18 to 49 50 to 64 65+

Male Female

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 Utah Behavioral Health Barometer

is available for download from the 

Substance Abuse and Mental Health 

Services Administration (SAMHSA) 

website (www.samhsa.gov/data 

/population-data-nsduh 

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

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

Utah Utah Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Utahns

In 2012, there were 1,586 admissions of 

Utahns ages 50 and older to substance 

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

218 per 100,000 people ages 50+. This 

rate was lower than the regional rate 

and the national average. Men made up 

82.7 percent of these admissions. Of all 

admissions, 67.7 percent were White/

Caucasian, 7.1 percent were Black/

African American, and 13.3 percent 

were Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

36.8% 40.8% 22.3%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Utah, Region 8, and the United States by Sex, 2012

375.1

1,132.1

383.2

72.5

246.4

120.3

0

200

400

600

800

1,000

1,200

Utah Region 8 U.S.

Male Female

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 Utahns Ages 50+ by Insurance Type 

In Utah, 77.4 percent of older adult 

admissions to SUD treatment were 

uninsured, 11.1 percent had Medicaid, 

7.2 percent had Medicare, and 

4.3 percent had private insurance.

SUD Treatment Admissions Among 

Utahns Ages 50+ by Primary Sources 

of Payment

Self-Pay Medicaid Other

6.1% 10.1% 83.7%

Self-pay data include private insurance.

Exhibit 8 and the accompanying text reflect the type of 

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

above represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Utah, Region 8, and the United States by Insurance 

Type, 2012

4.3%

11.1%

7.2%

77.4%

21.7%

5.0% 6.5%

66.8%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Private Medicaid Medicare None

Utah Region 8 U.S.

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 Utah Utah Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Utahns Ages 50+

Alcohol was the most frequently cited 

substance used by older Utahns in 

publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 62.3 percent of admissions 

among those ages 50+. This was lower 

than the regional rate and higher than 

the national rate.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Utah, Region 8, and the United States, 2012

62.3%

87.2%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Utah Region 8 U.S.

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 37.7 percent of older adult 

admissions to publicly funded 

treatment in Utah.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Utah, Region 8, and 

the United States, 2012

37.7%

12.8%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Utah Region 8 U.S.

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

Utah Utah 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 Utahns 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 Utahns 

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.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Utah, Region 8, 

and the United States, 2012

25.7% 26.0%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Utah Region 8 U.S.

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders

Source: TEDS, 2012

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

7

MENTAL HEALTH

Older Utahns 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 

Utahns experience FMD at a rate that is 

higher than the regional rate and lower 

than the national rates.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Utah, Region 8, and the United States, 2013

11.1%

11.7%

6.4%

10.5% 10.2%

5.7%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

Utah Region 8 U.S.

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Utahns Reporting Frequent Mental Distress by Age Group and Sex

Older men in Utah 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, 

14.2 percent of women in the 50–64 age 

group and 8.7 percent in the 65+ age 

group reported FMD, while 9.2 percent 

of men in the 50–64 age group and 

3.7 percent in the 65+ age group 

reported FMD.

Exhibit 13. Utahns Reporting Frequent Mental Distress 

by Age Group and Sex, 2013

8.8%

13.5%

9.2%

14.2%

3.7%

8.7%

0%

2%

4%

6%

8%

10%

12%

14%

16%

Male Female

18 to 49 50 to 64 65+

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
8

Utah Utah 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 Utahns.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 8.2% 6.9% 10.2%

Dissatisfied or very 

dissatisfied 4.2% 4.8% 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.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 Utah Utah Profile 2016

9

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

High Blood Pressure, and Coronary Disease

Older Americans who experience FMD 

are more likely to report that they have 

health problems. People with FMD 

were more than twice as likely to report 

having a stroke than those with some 

or no mental distress. They experienced 

coronary disease and heart attack at 

more than 1.6 times, diabetes at more 

than 1.4 times, and high blood pressure 

at nearly 1.2 times the rate of those with 

some or no mental distress.

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

10.1%

13.3% 13.2%

25.9%

60.6%

4.7%

7.6% 7.8%

17.7%

51.1%

0%

10%

20%

30%

40%

50%

60%

70%

Stroke Coronary disease Heart attack Diabetes High blood pressure

Frequent mental distress Some or no mental distress

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older Utahns Admitted to State Mental Health Services

Approximately 4.1 percent of the people served by the Utah mental health system were ages 65 and older. 

This represents more than 2,000 adults.

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

Wyoming
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

WYOMING’S POPULATION

Wyoming Population by Age Group

Wyoming is home to 584,153 people. Of 

these:

• 203,014 (34.8 percent) are over age 50.

• 119,459 (20.4 percent) are over age 60.

• 52,929 (9.1 percent) are over age 70.

• 19,761 (3.4 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 59.3 percent of the 80+ group. 

The racial/ethnic composition of older 

Wyomingites is as follows:

Race/Ethnicity of Wyomingites 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

95.6% 1.6% 1.1% 0.7% 0.1% 0.9% 5.4%

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. Wyoming Population by Age Group, 2014

40 39

44

40

35

42

34

16

8 

39

36

40

37

32

41

33

17

12

0

10

20

30

40

50

60

70

80

90

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 Wyomingites Is Growing

The proportion of Wyoming’s 

population that is 65 and older is 

growing while the proportion that 

is younger than 65 is shrinking. The 

U.S. Census Bureau estimates that 

26.5 percent of Wyoming’s population 

will be 65 and older by the year 2030, 

an increase of 56.0 percent from 2015.

Projected Population in Wyoming

Age Group 2015 2025 2030

Under 18 21.9% 20.1% 19.1%

18 to 44 32.9% 30.9% 28.8%

45 to 64 28.4% 24.7% 25.5%

65+ 16.8% 24.3% 26.5%

Source: U.S. Census Bureau, 2005

Exhibit 2. Wyoming Population by Age Group, 

2000–2030

0

20

40

60

80

100

120

140

160

180

200

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

Population in 1,000s

August 2016

Wyoming
2

Wyoming Wyoming Wyoming Profile 2016

SUICIDE AMONG OLDER WYOMINGITES

Region 8 Suicide Rates Compared With National Rates

Suicide data for Wyomingites of 

various ages were unavailable for 

2013. Therefore, the rates for Region 8 

(including Colorado, Montana, North 

Dakota, South Dakota, and Utah) are 

used instead.

The suicide rate among individuals ages 

50+ in Region 8 was higher than the rate 

among younger age groups. In 2013, 

the total suicide rate among all people 

ages 50+ was 25.7 per 100,000 people 

(10.8 for women and 41.9 for men). The 

rate among those ages 50–64 was higher 

than the rate in the United States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in Region 8 and the United 

States, 2013

19.7

17.0

29.1

20.7

13.0

10.6

19.0

16.1

0

5

10

15

20

25

30

35

All Under 50 50 to 64 65+

Suicide Rate per 100,000 Population 

Region 8 U.S.

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

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

WONDER Online Database, released 2015

Trends in Suicide Rates in Region 8

Suicide data for Wyomingites of 

various ages were unavailable. 

Therefore, the rates for Region 8 

are used instead.

The suicide rate among individuals 

in Region 8 ages 50+ fluctuated 

from a low of 20.5 per 100,000 in 

2004 to a high of 25.8 per 100,000 in 

2012. From 2004 to 2013, the rate was 

generally highest among those in the 

50–64 age group.

How a state reports suicides can 

vary from year to year. The number 

of suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

Exhibit 4. Trends in Suicide Rates in Region 8 by Age Group, 

2004–2013

0

5

10

15

20

25

30

35

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

All ages Under 50 50+ 50 to 64 65+

Suicide Rate per 100,000 Population

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

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

3

Wyoming

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER WYOMINGITES

30-Day Binge Drinking Among Older Wyomingites

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, 14.3 percent 

of Wyoming men ages 50–64 reported 

binge drinking in the past 30 days, while 

1.2 percent of those in the 65+ group 

reported similar behavior. 

Exhibit 5. Binge Drinking Rates in Wyoming by Age 

Group and Sex, 2013

31.8%

14.3% 

6.2%

15.9%

8.3%

1.2%

0%

5%

10%

15%

20%

25%

30%

35%

18 to 49 50 to 64 65+

Male Female

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 

Wyoming Behavioral Health Barometer

is available for download from the 

Substance Abuse and Mental Health 

Services Administration (SAMHSA) 

website (www.samhsa.gov/data 

/population-data-nsduh 

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

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.
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Wyoming Wyoming Wyoming Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Wyomingites

In 2012, there were 640 admissions 

of Wyomingites ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 315.2 per 100,000 

people ages 50+. This rate was lower 

than the regional rate and higher than 

the national average. Men made up 

72.5 percent of these admissions. Of all 

admissions, 87.5 percent were White/

Caucasian, 1.7 percent were Black/

African American, and 8.0 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

29.1% 40.7% 30.2%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Wyoming, Region 8, and the United States by Sex, 2012

463.3

1,132.1

383.2

171.1

246.4

120.3

0

200

400

600

800

1,000

1,200

Wyoming Region 8 U.S.

Male Female

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 Wyomingites Ages 50+ by Insurance Type 

In Wyoming, 84.3 percent of older 

adult admissions to SUD treatment were 

uninsured, 5.6 percent had Medicaid, 

and 10.2 percent had Medicare. There 

were no reported admissions for older 

adults who had private insurance.

SUD Treatment Admissions Among 

Wyomingites Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

0.0% 36.1% 63.9%

Self-pay data include private insurance.

Exhibit 8 and the accompanying text reflect the type of 

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

above represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Wyoming, Region 8, and the United States by 

Insurance Type, 2012

0.0% 5.6%

10.2%

84.3%

21.7%

5.0% 6.5%

66.8%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Private Medicaid Medicare None

Wyoming Region 8 U.S.

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 Wyoming Profile 2016

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Wyoming

Alcohol Use Disorder Treatment Admissions Among Wyomingites Ages 50+

Alcohol was the most frequently cited 

substance used by older Wyomingites 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 84.7 percent of admissions 

among those ages 50+. This was lower 

than the regional rate and higher than 

the national rate.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Wyoming, Region 8, and the United States, 

2012

84.7% 87.2%

62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Wyoming Region 8 U.S.

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 15.3 percent of older adult 

admissions to publicly funded 

treatment in Wyoming.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Wyoming, Region 8, 

and the United States, 2012

15.3%

12.8%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Wyoming Region 8 U.S.

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

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
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Wyoming Wyoming Wyoming 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 Wyomingites 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 

Wyomingites 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.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Wyoming, Region 

8, and the United States, 2012

27.3% 26.0%

33.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Wyoming Region 8

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders

U.S.

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
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Wyoming

MENTAL HEALTH

Older Wyomingites 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 

Wyomingites experience FMD at a rate 

that is lower than the regional and 

national rates.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Wyoming, Region 8, and the United States, 2013

11.1%

10.2%

5.2%

10.5% 10.2%

5.7%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

Wyoming Region 8 U.S.

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older Wyomingites Reporting Frequent Mental Distress by Age Group and Sex

Older men in Wyoming were more likely 

to indulge in binge drinking, but older 

women were more likely to report that 

they had FMD (14 days or more per 

30-day period). As Exhibit 13 shows, 

12.2 percent of women in the 50–64 age 

group and 6.4 percent in the 65+ age 

group reported FMD, while 8.3 percent 

of men in the 50–64 age group and 3.9 

percent in the 65+ age group reported 

FMD.

Exhibit 13. Wyomingites Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

7.2%

15.4%

8.3%

12.2%

3.9%

6.4%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

Male Female

18 to 49 50 to 64 65+

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013
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Wyoming Wyoming Wyoming 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 Wyomingites.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 7.7% 5.9% 10.8%

Dissatisfied or very 

dissatisfied 4.1% 4.9% 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.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

10.8%

18.1%

52.4%

0%

10%

20%

30%

40%

50%

60%

No mental distress Some mental distress Frequent mental distress

Proportion Reporting Poor Physical Health

Source: BRFSS, 2013
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Wyoming

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

High Blood Pressure, and Coronary Disease

Older Americans who experience FMD 

are more likely to report that they have 

health problems. People with FMD 

were more than twice as likely to report 

having a stroke than those with some 

or no mental distress. They experienced 

coronary disease and heart attack at 

more than 1.6 times, diabetes at more 

than 1.4 times, and high blood pressure 

at nearly 1.2 times the rate of those with 

some or no mental distress.

Exhibit 16. Individuals Ages 50+ in the United States 

With Mental Distress and Serious Health Problems, 2013

10.1%

13.3% 13.2%

25.9%

60.6%

4.7%

7.6% 7.8%

17.7%

51.1%

0%

10%

20%

30%

40%

50%

60%

70%

Stroke Coronary disease Heart attack Diabetes High blood pressure

Frequent mental distress Some or no mental distress

Proportion Reporting Health Problems by Mental Health Category

Source: BRFSS, 2013

Older Wyomingites Admitted to State Mental Health Services

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

older. This represents more than 710 adults.

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