OLDER ADULTS BEHAVIORAL HEALTH PROFILES
 

REGION 2 

  NEW JERSEY

NEW YORK 

PUERTO RICO 

U.S. VIRGIN ISLANDS 

NY

NJ

PR VI

A Behavioral Health Resource 

SAMHSA’s State Technical Assistance Contract 

April 2016 
OLDER ADULTS BEHAVIORAL HEALTH PROFILES

OVERVIEW

The Substance Abuse and Mental Health Services Administration 

recognizes the importance of behavioral health for older adults and 

the key role states, territories, 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 and territories. 

The Older Adults Behavioral Health Profiles help states, territories, 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 and territory trends with 

those in the region and the nation. State, territory, and community 

administrators, planners, and providers can use the information in 

these profiles and their own data, knowledge, and experience to 

establish and implement policies that improve the health and future 

of our valued older citizens.

Disclaimer: Data were current at the time this document was prepared.

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

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

New Jersey
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

April 2016

NEW JERSEY’S POPULATION

New Jersey Population by Age Group

New Jersey is home to 8,938,175 people. 

Of these:

• 3,157,445 (35.3 percent) are over age 50.

• 1,830,792 (20.5 percent) are over age 60.

• 891,368 (10.0 percent) are over age 70.

• 365,686 (4.1 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 64.0 percent of the 80+ group. 

The racial/ethnic composition of older 

New Jerseyans is as follows:

Race/Ethnicity of New Jerseyans 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

79.5% 0.4% 11.9% 7.3% 0.1% 0.9% 11.6%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

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

Exhibit 1. New Jersey Population by Age Group, 

2014

553 590 585 571 614 644

442

231

132

531

561 559 576

641

682

498

295

234

0

200

400

600

800

1,000

1,200

1,400

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 New Jerseyans Is Growing

The proportion of New Jersey’s 

population that is 65 and older is 

growing while the proportion that 

is younger than 65 is shrinking. 

The U.S. Census Bureau estimates that 

20.0 percent of New Jersey’s population 

will be 65 and older by the year 2030, 

an increase of 41.5 percent from 2015.

Projected Population in New Jersey

Age Group 2015 2025 2030

Under 18 22.7% 22.4% 22.2%

18 to 44 35.0% 34.2% 33.6%

45 to 64 27.3% 25.1% 24.2%

65+ 15.0% 18.3% 20.0%

Source: U.S. Census Bureau, 2005

Exhibit 2. New Jersey Population by Age Group, 

2000–2030

0

500

1,000

1,500

2,000

2,500

3,000

3,500

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

Population in 1,000s

New Jersey
2

New Jersey New Jersey Profile 2016

SUICIDE AMONG OLDER NEW JERSEYANS

New Jersey Suicide Rate Compared With Regional and National Rates

The suicide rate among New Jerseyans 

ages 50 and older is higher than the rate 

among younger age groups. In 2013, the 

total suicide rate among all people ages 

50+ was 12.1 per 100,000 people (4.9 

for women and 20.6 for men). The rate 

among those ages 50–64 was equal to 

the rate in the region (calculated based 

on data from New Jersey and New York) 

and lower than the rate in the United 

States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in New Jersey, Region 2, and 

the United States, 2013

8.5

6.6

13.3

10.4

8.6

6.7

13.3

10.5

13.0

10.6

19.0

16.1

0

2

4

6

8

10

12

14

16

18

20

All Under 50 50 to 64 65+

New Jersey Region 2 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 New Jersey

The suicide rate among New 

Jerseyans ages 50+ fluctuated from 

a low of 7.9 per 100,000 in 2005 to 

a high of 12.1 per 100,000 in 2013. 

From 2004 to 2013, the rate was 

generally highest among those in 

the 50–64 age group.

How a state reports suicides can 

vary from year to year. The number 

of suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

Exhibit 4. Trends in Suicide Rates in New Jersey by Age 

Group, 2004–2013

0

2

4

6

8

10

12

14

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 New Jersey New Jersey Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER NEW JERSEYANS

30-Day Binge Drinking Among Older New Jerseyans

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, 16.7 percent 

of New Jersey men ages 50–64 reported 

binge drinking in the past 30 days, while 

6.7 percent of those in the 65+ group 

reported similar behavior. 

Exhibit 5. Binge Drinking Rates in New Jersey by Age 

Group and Sex, 2013

28.5%

16.7%

6.7%

16.9%

9.1%

2.3%

0%

5%

10%

15%

20%

25%

30%

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 New Jersey Behavioral Health 

Barometer is available for download 

from the Substance Abuse and 

Mental Health Services Administration 

(SAMHSA) website (www.samhsa.gov 

/data/population-data-nsduh 

/reports?tab=33). 0%

1%

2%

3%

4%

5%

6%

7%

8%

9%

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

50 to 54 55 to 59 60 to 64

Proportion Using in Past Month

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

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

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

provides a list of drugs included in its survey in the NSDUH methodological summary.
4

New Jersey New Jersey Profile 2016

Admissions to Substance Use Disorder Treatment Among Older New Jerseyans

In 2012, there were 9,303 admissions 

of New Jerseyans ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 294.6 per 100,000 

people ages 50+. This rate was lower 

than the regional rate and higher than 

the national average. Men made up 

69.4 percent of these admissions. Of all 

admissions, 65.9 percent were White/

Caucasian, 32.6 percent were Black/

African American, and 9.8 percent 

were Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

45.1% 29.1% 25.7%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in New Jersey, Region 2, and the United States by Sex, 

2012

445.3

1,044.8

383.2

166.8

253.7

120.3

0

200

400

600

800

1,000

1,200

New Jersey Region 2 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 New Jerseyans Ages 50+ by Insurance Type

In New Jersey, 39.7 percent of older 

adult admissions to SUD treatment 

were uninsured, 26.9 percent had 

Medicaid, 7.2 percent had Medicare, 

and 26.2 percent had private insurance.

SUD Treatment Admissions Among 

New Jerseyans Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

33.8% 9.6% 56.6%

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 New Jersey, Region 2, and the United States by 

Insurance Type, 2012

26.2% 26.9%

7.2%

39.7%

29.2%

25.4%

7.2%

38.3%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

Private Medicaid Medicare None

New Jersey Region 2 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 New Jersey New Jersey Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among New Jerseyans Ages 50+

Alcohol was the most frequently cited 

substance used by older New Jerseyans 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 52.1 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 New Jersey, Region 2, and the United States, 

2012

52.1%

60.6% 62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

New Jersey Region 2 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 47.9 percent of older adult 

admissions to publicly funded 

treatment in New Jersey.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in New Jersey, Region 2, 

and the United States, 2012

47.9%

39.4%

37.9%

0%

10%

20%

30%

40%

50%

60%

New Jersey Region 2 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

New Jersey New Jersey Profile 2016

Drug-Related Emergency Department Visits Involving Pharmaceutical Misuse 

and Abuse by Older Adults

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

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

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

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

DAWN Report:

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

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

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

made by persons aged 70 or older 

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

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

antidepressants (8.6 percent) 

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

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

hospital 

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

CO-OCCURRING SUBSTANCE USE AND MENTAL DISORDERS

Older New Jerseyans in SUD Treatment With Co-Occurring Mental Disorders

The national literature shows a strong 

relationship between substance use 

and mental disorders. Studies show 

that 30–80 percent of individuals with 

a substance use or mental disorder 

also have a co-occurring disorder. 

Exhibit 11 shows the proportion of 

SUD treatment admissions of New 

Jerseyans ages 50+ with a co-occurring 

mental disorder. This rate is lower than 

the regional rate and higher than 

the national average. However, state 

reporting practices are a factor in 

these results.

48.1% 49.0%

33.7%

0%

10%

20%

30%

40%

50%

60%

New Jersey Region 2 U.S.

Proportion of Treatment Admissions 50+ With Co-Occurring Disorders -

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

Exhibit 11. SUD Treatment Admissions of Adults Ages 

50+ With a Co-Occurring Mental Disorder in New Jersey, 

Region 2, and the United States, 2012
Alabama ALABAMA Profile 2015 New Jersey New Jersey Profile 2016

7

MENTAL HEALTH

Older New Jerseyans 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 New 

Jerseyans in the 50–64 age group 

experience FMD at a rate that is lower 

than the regional and national rates, 

while those in the 65+ age group 

experience it at a rate that is roughly 

similar to the regional and national 

rates.

Exhibit 12. Individuals Reporting Frequent Mental 

Distress in New Jersey, Region 2, and the United States, 

2013

9.9%

11.7%

7.2%

11.7%

13.1%

7.4%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

New Jersey Region 2 U.S.

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older New Jerseyans Reporting Frequent Mental Distress by Age Group 

and Sex

Older men in New Jersey were more 

likely to indulge in binge drinking, but 

older women were more likely to report 

that they had FMD (14 days or more 

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

15.4 percent of women in the 50–64 age 

group and 8.0 percent in the 65+ age 

group reported FMD, while 7.6 percent 

of men in the 50–64 age group and 

5.9 percent in the 65+ age group 

reported FMD.

Exhibit 13. New Jerseyans Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

9.3%

10.5%

7.6%

15.4%

5.9%

8.0%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

Male Female

Proportion Reporting Frequent Mental Distress

18 to 49 50 to 64 65+

Source: BRFSS, 2013
8

New Jersey New Jersey Profile 2016

Other Measures of Mental Health

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

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

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

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

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

Exhibit 14 presents the results of these surveys among older New Jerseyans.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 10.0% 9.7% 10.3%

Dissatisfied or very 

dissatisfied 5.1% 5.4% 4.7%

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 New Jersey New Jersey 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

Proportion Reporting Health Problems by Mental Health Category

Frequent mental distress Some or no mental distress

Source: BRFSS, 2013

Older New Jerseyans Admitted to State Mental Health Services

Approximately 15.1 percent of the people served by the New Jersey mental health system were ages 65 

and older. This represents more than 52,270 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014
10 New Jersey New Jersey Profile 2016

DATA SOURCES

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

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

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

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

reported to CDC.

CENTERS FOR DISEASE CONTROL AND PREVENTION, NATIONAL CENTER FOR HEALTH 

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

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

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

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

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

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

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

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

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

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

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

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

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

outcome information.

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

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

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

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

conditions.

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

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

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

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

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

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

be counted as two admissions.

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

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

New York
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

April 2016

NEW YORK’S POPULATION

New York Population by Age Group

New York is home to 19,746,227 people. 

Of these:

• 6,836,587 (34.6 percent) are over age 50.

• 4,045,153 (20.5 percent) are over age 60.

• 1,965,192 (10.0 percent) are over age 70.

• 802,640 (4.1 percent) are ages 80 and 

older.

The proportion of women rises fairly 

steadily in each age group, and women 

make up 63.8 percent of the 80+ group. 

The racial/ethnic composition of older 

New Yorkers is as follows:

Race/Ethnicity of New Yorkers 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

76.0% 0.6% 15.1% 7.1% 0.1% 1.1% 12.3%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

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

Exhibit 1. New York Population by Age Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older New Yorkers Is Growing

The proportion of New York’s 

population that is 65 and older is 

growing while the proportion that 

is younger than 65 is shrinking. 

The U.S. Census Bureau estimates that 

20.1 percent of New York’s population 

will be 65 and older by the year 2030, 

an increase of 33.1 percent from 2015.

Projected Population in New York

Age Group 2015 2025 2030

Under 18 22.3% 22.4% 22.2%

18 to 44 36.2% 35.2% 34.7%

45 to 64 26.5% 24.0% 23.0%

65+ 15.1% 18.5% 20.1%

Source: U.S. Census Bureau, 2005

New York

1,188 1,243

1,462

1,291 1,279 1,348

973

507

290

1,136

1,194

1,455

1,324 1,338

1,443

1,107

655

512

0

500

1,000

1,500

2,000

2,500

3,000

3,500

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

Population in 1,000s

Male Female

Exhibit 2. New York Population by Age Group, 2000–

2030

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

2000 2005 2010 2015 2020 2025 2030

Under 18 18 to 44 45 to 64 65+

Population in 1,000s
2

New York New York Profile 2016

SUICIDE AMONG OLDER NEW YORKERS

New York Suicide Rate Compared With Regional and National Rates

The suicide rate among New Yorkers 

ages 50 and older is higher than the rate 

among younger age groups. In 2013, 

the total suicide rate among all people 

ages 50+ was 12.2 per 100,000 people 

(5.5 for women and 20.1 for men). The 

rate among those ages 50–64 was higher 

than the rate in the region (calculated 

based on data from New Jersey and 

New York) and lower than the rate in the 

United States.

States vary in their reporting of suicides. 

The suicide rate is influenced by these 

reporting practices.

Exhibit 3. Suicide Rates in New York, Region 2, and the 

United States, 2013

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

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

WONDER Online Database, released 2015

8.6

6.7

13.4

10.5

8.6

6.7

13.3

10.5

13.0

10.6

19.0

16.1

0

2

4

6

8

10

12

14

16

18

20

All Under 50 50 to 64 65+

New York Region 2 U.S.

Suicide Rate per 100,000 Population

Trends in Suicide Rates in New York

The suicide rate among New Yorkers 

ages 50+ fluctuated from a low of 

8.1 per 100,000 in 2004 to a high of 

12.2 per 100,000 in 2013. From 2004 

to 2013, the rate was highest among 

those in the 50–64 age group.

How a state reports suicides can 

vary from year to year. The number 

of suicides is generally low, so even a 

small difference in reported numbers 

may make the rate fluctuate widely.

Exhibit 4. Trends in Suicide Rates in New York by Age Group, 

2004–2013

0

2

4

6

8

10

12

14

16

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 New York New York Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER NEW YORKERS

30-Day Binge Drinking Among Older New Yorkers

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 New York men ages 50–64 reported 

binge drinking in the past 30 days, while 

8.4 percent of those in the 65+ group 

reported similar behavior. 

Exhibit 5. Binge Drinking Rates in New York by Age 

Group and Sex, 2013

30.9%

16.3%

8.4%

17.2%

9.2%

3.4%

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 

New York 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

New York New York Profile 2016

Admissions to Substance Use Disorder Treatment Among Older New Yorkers

In 2012, there were 59,393 admissions 

of New Yorkers ages 50 and older 

to substance use disorder (SUD) 

treatment in state-funded treatment 

programs, a rate of 868.8 per 100,000 

people ages 50+. This rate was higher 

than the regional rate and the national 

average. Men made up 78.6 percent 

of these admissions. Of all admissions, 

39.8 percent were White/Caucasian, 

41.5 percent were Black/African 

American, and 18.4 percent were 

Hispanic.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

48.7% 10.9% 40.4%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in New York, Region 2, and the United States by Sex, 2012

1,497.5

1,044.8

383.2 341.4

253.7

120.3 0

200

400

600

800

1,000

1,200

1,400

1,600

New York Region 2 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 Individuals in Region 2 Ages 50+ by 

Insurance Type 

States may choose not to report 

some of the fields to TEDS, including 

information on treatment admission 

insurance types. These data were not 

reported by New York in 2012. Therefore, 

the rates for Region 2 are used instead.

In Region 2, 38.3 percent of older 

adult admissions to SUD treatment 

were uninsured, 25.4 percent had 

Medicaid, 7.2 percent had Medicare, 

and 29.2 percent had private insurance.

SUD Treatment Admissions Among 

New Yorkers Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

Data not 

available

Data not 

available

Data not 

available

Exhibit 8 and the accompanying text reflect the type of 

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

above represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Region 2 and the United States by Insurance Type, 2012

29.2%

25.4%

7.2%

38.3%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

Private Medicaid Medicare None

Region 2 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 New York New York Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among New Yorkers Ages 50+

Alcohol was the most frequently cited 

substance used by older New Yorkers 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 61.8 percent of admissions 

among those ages 50+. This was 

higher than the regional rate and 

lower than the national rate.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in New York, Region 2, and the United States, 

2012

61.8% 60.6% 62.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

New York Region 2 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 38.2 percent of older adult 

admissions to publicly funded 

treatment in New York.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in New York, Region 2, 

and the United States, 2012

38.2%

39.4%

37.9%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

New York Region 2 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

New York New York Profile 2016

Drug-Related Emergency Department Visits Involving Pharmaceutical Misuse 

and Abuse by Older Adults

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

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

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

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

DAWN Report:

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

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

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

made by persons aged 70 or older 

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

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

antidepressants (8.6 percent) 

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

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

hospital 

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

CO-OCCURRING SUBSTANCE USE AND MENTAL DISORDERS

Older New Yorkers in SUD Treatment With Co-Occurring Mental Disorders

The national literature shows a strong 

relationship between substance use 

and mental disorders. Studies show 

that 30–80 percent of individuals with 

a substance use or mental disorder 

also have a co-occurring disorder.

Exhibit 11 shows the proportion of 

SUD treatment admissions of New 

Yorkers 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 New York, Region 2, 

and the United States, 2012

49.7% 49.0%

33.7%

0%

10%

20%

30%

40%

50%

60%

New York Region 2 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 New York New York Profile 2016

7

MENTAL HEALTH

Older New Yorkers Reporting Frequent Mental Distress

BRFSS, a household survey conducted 

in all 50 states and several territories, 

asks the following question: “Now 

thinking about your mental health, 

which includes stress, depression, 

and problems with emotions, for how 

many days during the past 30 days 

was your mental health not good?” 

Those individuals reporting 14 or more 

“Yes” days in response to this question 

experience frequent mental distress 

(FMD). Exhibit 12 shows that older New 

Yorkers experience FMD at a rate that 

is roughly similar to the regional and 

national rates.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in New York, Region 2, and the United States, 2013

12.2%

12.8%

7.2%

11.7%

13.1%

7.4%

12.3%

13.0%

7.2%

0%

2%

4%

6%

8%

10%

12%

14%

18 to 49 50 to 64 65+

New York Region 2 U.S.

Proportion Reporting Frequent Mental Distress

Source: BRFSS, 2013

Older New Yorkers Reporting Frequent Mental Distress by Age Group 

and Sex

Older men in New York 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, 

14.0 percent of women in the 50–64 age 

group and 8.5 percent in the 65+ age 

group reported FMD, while 11.4 percent 

of men in the 50–64 age group and 

5.4 percent in the 65+ age group 

reported FMD.

Exhibit 13. New Yorkers Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

11.3%

13.1%

11.4%

14.0%

5.4%

8.5%

0%

2%

4%

6%

8%

10%

12%

14%

16%

Male Female

Proportion Reporting Frequent Mental Distress

18 to 49 50 to 64 65+

Source: BRFSS, 2013
8

New York New York Profile 2016

Other Measures of Mental Health

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

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

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

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

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

Exhibit 14 presents the results of these surveys among older New Yorkers.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 11.5% 9.7% 13.9%

Dissatisfied or very 

dissatisfied 6.1% 7.5% 4.1%

Source: BRFSS, 2010

Individuals With Frequent Mental Distress Report High Rates of Poor 

Physical Health

Older Americans who experienced FMD 

were more likely to report that their 

physical health was poor (14 days or 

more in the past 30-day period when 

physical health was “not good”). As 

shown in Exhibit 15, although nearly 

11 percent of older Americans with no 

mental distress reported poor physical 

health, more than 50 percent of those 

with FMD reported poor physical 

health.

Exhibit 15. Individuals Ages 50+ in the United States 

Reporting Poor Physical Health by Level of Mental 

Distress, 2013

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 New York New York 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

Proportion Reporting Health Problems by Mental Health Category

Frequent mental distress Some or no mental distress

Source: BRFSS, 2013

Older New Yorkers Admitted to State Mental Health Services

Approximately 7.1 percent of the people served by the New York mental health system were ages 65 and 

older. This represents more than 51,660 adults.

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

Puerto Rico
OLDER ADULTS BEHAVIORAL HEALTH PROFILE

April 2016

PUERTO RICO’S POPULATION

Puerto Rico Population by Age Group

Puerto Rico is home to 3,548,397 people. 

Of these:

• 1,282,082 (36.1 percent) are over age 50.

• 831,148 (23.4 percent) are over age 60.

• 420,852 (11.9 percent) are over age 70.

• 146,963 (4.1 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 

Puerto Ricans is as follows:

Race/Ethnicity of Puerto Ricans 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

73.1% 0.3% 9.2% 0.1% 0.0% 17.3% 99.0%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

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

Exhibit 1. Puerto Rico Population by Age Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older Adults in Region 2 Is Growing

Recent population projections for Puerto 

Rico are unavailable. Therefore, projections for Region 2 (calculated based on 

data from New Jersey and New York) 

are used instead.

The U.S. Census Bureau estimates that 

20.1 percent of Region 2’s population 

will be 65 and older by the year 2030, 

an increase of 35.8 percent from 2015.

Projected Population in Region 2

Age Group 2015 2025 2030

Under 18 22.4% 22.4% 22.2%

18 to 44 35.8% 34.9% 34.4%

45 to 64 26.7% 24.3% 23.4%

65+ 15.0% 18.4% 20.1%

Source: U.S. Census Bureau, 2005

Exhibit 2. Region 2 Population by Age Group, 

2000–2030

Puerto Rico
2

Puerto Rico Puerto Rico Profile 2016

SUICIDE AMONG OLDER ADULTS IN REGION 2

Region 2 Suicide Rates Compared With National Rates

Recent suicide data for Puerto Rico 

are not available from the Centers for 

Disease Control and Prevention (CDC) 

mortality databases. Therefore, the rates 

for Region 2 (calculated based on data 

from New Jersey and New York) are used 

instead.

The suicide rate among individuals in 

Region 2 ages 50 and older is higher than 

the rate among younger age groups. In 

2013, the total suicide rate among all 

people ages 50+ was 12.1 per 100,000 

people (5.3 for women and 20.3 for men). 

The rate among those ages 50–64 was 

lower than the rate in the United States.

States and territories vary in their 

reporting of suicides. The suicide rate is 

influenced by these reporting practices.

Exhibit 3. Suicide Rates in Region 2 and the United 

States, 2013

Source: 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 2

Recent suicide data for Puerto Rico 

are not available from the CDC 

mortality databases. Therefore, the 

rates for Region 2 are used instead.

The suicide rate among individuals 

in Region 2 ages 50+ fluctuated from 

a low of 8.2 per 100,000 in 2004 to 

a high of 12.1 per 100,000 in 2013. 

From 2004 to 2013, the rate was 

generally highest among those in the 

50–64 age group. 

How a state or territory 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 2 by Age Group, 

2004–2013

0

2

4

6

8

10

12

14

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Suicide Rate per 100,000 Population

All ages Under 50 50+ 50 to 64 65+

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

Online Database, released 2015
Alabama ALABAMA Profile 2015 Puerto Rico Puerto Rico Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER PUERTO RICANS

30-Day Binge Drinking Among Older Puerto Ricans

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, 22.1 percent 

of Puerto Rico men ages 50–64 reported 

binge drinking in the past 30 days, while 

7.9 percent of those in the 65+ group 

reported similar behavior. 

Exhibit 5. Binge Drinking Rates in Puerto Rico by Age 

Group and Sex, 2013

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

Illicit Drug Use Among Older Americans

Nationally, the rate of illicit drug use 

among older adults ages 50–64 more 

than doubled from 2002 to 2013. 

This development partially reflects 

the entrance into this age group 

of the baby boom cohort, whose 

rates of illicit drug use have been 

higher than those of older cohorts. 

Although territory-specific data are 

not available, the Behavioral Health 

Barometers for states in Region 2 

are available for download from 

the Substance Abuse and Mental 

Health Services Administration 

(SAMHSA) website (www.samhsa.gov 

/data/population-data-nsduh 

/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

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

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

provides a list of drugs included in its survey in the NSDUH methodological summary.
4

Puerto Rico Puerto Rico Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Puerto Ricans

In 2012, there were 574 admissions 

of Puerto Ricans ages 50 and older 

to substance use disorder (SUD) 

treatment in territory-funded treatment 

programs, a rate of 44.8 per 100,000 

people ages 50+. This rate was lower 

than the regional rate and the national 

average. Men made up 95.6 percent of 

these admissions. Of all admissions, 

1.9 percent were White/Caucasian, 

and 99.8 percent were Hispanic. 

There were no reported Black/African 

American admissions.

The principal sources of referral to 

treatment among those ages 50 and 

older were: 

Self-Referral Criminal Justice Other

19.1% 72.9% 7.9%

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

Puerto Rico, Region 2, and the United States by Sex, 2012

96.0

1,044.8

383.2

3.5

253.7

120.3

0

200

400

600

800

1,000

1,200

Puerto Rico Region 2 U.S.

SUD Admission Rate per 100,000 Population

Male Female

3.5

Source: Treatment Episode Data Set (TEDS), 20121

1

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

territories report all clients admitted to publicly financed treatment; however, states and territories are inconsistent in applying the guidelines. States and territories 

may structure and implement different quality controls over the data. For example, states and territories 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 Puerto Ricans Ages 50+ by Insurance Type 

In Puerto Rico, 16.5 percent of older 

adult admissions to SUD treatment were 

uninsured, 7.6 percent had Medicare, 

and 75.9 percent private insurance. There 

were no reported Medicaid admissions.

SUD Treatment Admissions Among 

Puerto Ricans Ages 50+ by Primary 

Sources of Payment

Self-Pay Medicaid Other

65.1% 0.5% 34.3%

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 Puerto Rico, Region 2, and the United States by 

Insurance Type, 2012

75.9%

7.6%

16.5%

29.2%

25.4%

7.2%

38.3%

14.9%

20.4%

10.8%

53.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Private Medicaid Medicare None

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

Puerto Rico Region 2 U.S.

0.0%

Source: TEDS, 2012

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

5

Alcohol Use Disorder Treatment Admissions Among Puerto Ricans Ages 50+

Alcohol was the most frequently cited 

substance used by older Puerto Ricans 

in publicly financed SUD treatment in 

2012. It was mentioned as a substance 

of use in 76.0 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 Puerto Rico, Region 2, and the United States, 

2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions for Non-Alcohol Substance Use

Substances other than alcohol were 

cited as the primary substances of 

use for 24.0 percent of older adult 

admissions to publicly funded 

treatment in Puerto Rico.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Puerto Rico, 

Region 2, and the United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

Puerto Rico Puerto Rico 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 Puerto Ricans 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 Puerto 

Ricans ages 50+ with a co-occurring 

mental disorder. This rate is lower than 

the regional rate and the national 

average. However, state and territory 

reporting practices are a factor in 

these results.

Exhibit 11. SUD Treatment Admissions of Adults Ages 

50+ With a Co-Occurring Mental Disorder in Puerto Rico, 

Region 2, and the United States, 2012

Source: TEDS, 2012

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

7

MENTAL HEALTH

Older Puerto Ricans 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 

Puerto Ricans experience FMD at a rate 

that is higher than the regional and 

national rates.

Exhibit 12. Individuals Reporting Frequent Mental Distress 

in Puerto Rico, Region 2, and the United States, 2013

Source: BRFSS, 2013

Older Puerto Ricans Reporting Frequent Mental Distress by Age Group and Sex

Older men in Puerto Rico were more 

likely to indulge in binge drinking, but 

older women were more likely to report 

that they had FMD (14 days or more 

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

22.6 percent of women in the 50–64 age 

group and 9.1 percent in the 65+ age 

group reported FMD, while 15.0 percent 

of men in the 50–64 age group and 

8.1 percent in the 65+ age group 

reported FMD.

Exhibit 13. Puerto Ricans Reporting Frequent Mental 

Distress by Age Group and Sex, 2013

Source: BRFSS, 2013
8

Puerto Rico Puerto Rico 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 Puerto Ricans.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 9.4% 9.4% 9.5%

Dissatisfied or very 

dissatisfied 3.4% 4.3% 2.2%

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 Puerto Rico Puerto Rico 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

Proportion Reporting Health Problems by Mental Health Category

Frequent mental distress Some or no mental distress

Source: BRFSS, 2013

Older Puerto Ricans Admitted to Territory Mental Health Services

Approximately 4.9 percent of the people served by the Puerto Rico mental health system were ages 65 

and older. This represents more than 760 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2014
10 Puerto Rico Puerto Rico 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 and territories 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 and territories 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

U.S. Virgin Islands
April 2016

OLDER ADULTS BEHAVIORAL HEALTH PROFILE

REGION 2’S POPULATION

Region 2 Population by Age Group

Detailed demographic U.S. Census Bureau 

data on older U.S. Virgin Islanders are 

unavailable. Therefore, the estimates for 

Region 2 (which includes New Jersey, New 

York, and Puerto Rico) are used instead. 

Region 2 is home to 32,232,799 people. 

Of these:

• 11,276,114 (35.0 percent) are over age 50.

• 6,707,093 (20.8 percent) are over age 60.

• 3,277,412 (10.2 percent) are over age 70.

• 1,315,289 (4.1 percent) are ages 80 and 

older.

Race/Ethnicity of Individuals in Region 2 

Ages 50+

White AI/AN Black Asian NH/PI Other Hispanic

76.6% 0.5% 13.5% 6.4% 0.1% 2.9% 22.0%

Source: U.S. Census Bureau, 2015

AI/AN stands for American Indian and Alaska Native. 

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

Exhibit 1. Region 2 Population by Age Group, 2014

Source: U.S. Census Bureau, 2015

The Number of Older Adults in Region 2 Is Growing

Recent population projections for the 

U.S. Virgin Islands are unavailable. 

Therefore, projections for Region 2 

(calculated based on data from New 

Jersey and New York) are used instead.

The U.S. Census Bureau estimates that 

20.1 percent of Region 2’s population 

will be 65 and older by the year 2030, 

an increase of 35.8 percent from 2015.

Projected Population in Region 2

Age Group 2015 2025 2030

Under 18 22.4% 22.4% 22.2%

18 to 44 35.8% 34.9% 34.4%

45 to 64 26.7% 24.3% 23.4%

65+ 15.0% 18.4% 20.1%

Source: U.S. Census Bureau, 2005

Exhibit 2. Region 2 Population by Age Group, 

2000–2030

U.S. Virgin Islands
2

U.S. Virgin Islands U.S. Virgin Islands Profile 2016

SUICIDE AMONG OLDER ADULTS IN REGION 2

Region 2 Suicide Rates Compared With National Rates

Recent suicide data for the U.S. Virgin 

Islands are not available from the Centers 

for Disease Control and Prevention (CDC) 

mortality databases. Therefore, the rates 

for Region 2 (calculated based on data 

from New Jersey and New York) are used 

instead.

The suicide rate among individuals in 

Region 2 ages 50 and older is higher than 

the rate among younger age groups. In 

2013, the total suicide rate among all 

people ages 50+ was 12.1 per 100,000 

people (5.3 for women and 20.3 for men). 

The rate among those ages 50–64 was 

lower than the rate in the United States.

States and territories vary in their 

reporting of suicides. The suicide rate is 

influenced by these reporting practices.

Exhibit 3. Suicide Rates in Region 2 and the United 

States, 2013

Source: 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 2

Recent suicide data for the U.S. Virgin 

Islands are not available from the CDC 

mortality databases. Therefore, the 

rates for Region 2 are used instead.

The suicide rate among individuals 

in Region 2 ages 50+ fluctuated from 

a low of 8.2 per 100,000 in 2004 to 

a high of 12.1 per 100,000 in 2013. 

From 2004 to 2013, the rate was 

generally highest among those in 

the 50‒64 age group. 

How a state or territory 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 2 by Age Group

2004–2013

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

Online Database, released 2015

, 
Alabama ALABAMA Profile 2015 U.S. Virgin Islands U.S. Virgin Islands Profile 2016

3

SUBSTANCE USE DISORDER AND SUBSTANCE USE DISORDER 

TREATMENT AMONG OLDER ADULTS IN REGION 2

30-Day Binge Drinking Among Older Adults in Region 2

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. Recent data for the U.S. Virgin 

Islands are unavailable. Therefore, data 

for Region 2 are used instead. As Exhibit 5 

shows, 17.0 percent of Region 2 men ages 

50–64 reported binge drinking in the past 

30 days, while 7.9 percent of those in the 

65+ group reported similar behavior. 

Exhibit 5. Binge Drinking Rates in Region 2 by Age 

Group and Sex, 2013

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

Illicit Drug Use Among Older Americans

Nationally, the rate of illicit drug use 

among older adults ages 50–64 more 

than doubled from 2002 to 2013. 

This development partially reflects the 

entrance into this age group of the 

baby boom cohort, whose rates of illicit 

drug use have been higher than those 

of older cohorts. Although territoryspecific data are not available, the 

Behavioral Health Barometers for 

states in Region 2 are available 

for download from the Substance 

Abuse and Mental Health Services 

Administration (SAMHSA) website 

(www.samhsa.gov/data/population

-data-nsduh/reports?tab=33).

Exhibit 6. Illicit Drug Use Among Older Americans, 

2002–2013

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

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

provides a list of drugs included in its survey in the NSDUH methodological summary.
4

U.S. Virgin Islands U.S. Virgin Islands Profile 2016

Admissions to Substance Use Disorder Treatment Among Older Adults 

in Region 2

Treatment Episode Data Set (TEDS) data 

for the U.S. Virgin Islands in 2012 are 

unavailable. Therefore, data for Region 2 

are used instead.

In 2012, there were 69,269 admissions of 

individuals in Region 2 ages 50 and older 

to substance use disorder (SUD) treatment 

in state- and territory-funded treatment 

programs. Of all admissions, 43.0 percent 

were White/Caucasian, 40.0 percent were 

Black/African American, and 17.9 percent 

were Hispanic.

The principal sources of referral to 

treatment among those ages 50 and older 

were:

Self-Referral Criminal Justice Other

47.8% 13.7% 38.4%

Exhibit 7. SUD Treatment Admissions of Adults Ages 50+ 

in Region 2 and the United States by Sex, 2012

Source: Treatment Episode Data Set (TEDS), 20121

Data include only those clients reported to SAMHSA.

1

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

territories report all clients admitted to publicly financed treatment; however, states and territories are inconsistent in applying the guidelines. States and territories 

may structure and implement different quality controls over the data. For example, states and territories may collect different categories of information to answer 

TEDS questions. Information is then “walked over” to TEDS definitions.

SUD Treatment Admissions Among Individuals in Region 2 Ages 50+ 

by Insurance Type

TEDS data for the U.S. Virgin Islands in 

2012 are unavailable. Therefore, data 

for Region 2 are used instead.

In Region 2, 38.3 percent of older 

adult admissions to SUD treatment 

were uninsured, 25.4 percent had 

Medicaid, 7.2 percent had Medicare, 

and 29.2 percent had private insurance. 

SUD Treatment Admissions Among 

U.S. Virgin Islanders Ages 50+ by 

Primary Sources of Payment

Self-Pay Medicaid Other

Data not 

available

Data not 

available

Data not 

available

Exhibit 8 and the accompanying text reflect the type of 

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

above represents primary sources of payment.

Exhibit 8. SUD Treatment Admissions of Adults Ages 50+ 

in Region 2 and the United States by Insurance Type, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
Alabama ALABAMA Profile 2015 U.S. Virgin Islands U.S. Virgin Islands Profile 2016

5

Alcohol Use Disorder Treatment Admissions Among Individuals in Region 2 

Ages 50+

TEDS data for the U.S. Virgin Islands in 

2012 are unavailable. Therefore, data 

for Region 2 are used instead.

Alcohol was the most frequently cited 

substance used by older individuals 

in Region 2 in publicly financed SUD 

treatment in 2012. It was mentioned 

as a substance of use in 60.6 percent 

of admissions among those ages 50+. 

This was lower than the national rate.

Exhibit 9. Alcohol Use Treatment Admissions of Adults 

Ages 50+ in Region 2 and the United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.

SUD Treatment Admissions for Non-Alcohol Substance Use

TEDS data for the U.S. Virgin Islands 

in 2012 are unavailable. Therefore, 

data for Region 2 are used instead.

Substances other than alcohol were 

cited as the primary substances 

of use for 39.4 percent of older 

adult admissions to publicly funded 

treatment in Region 2.

Exhibit 10. Non-Alcohol Substance Use Treatment 

Admissions of Adults Ages 50+ in Region 2 and the 

United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
6

U.S. Virgin Islands U.S. Virgin Islands Profile 2016

Drug-Related Emergency Department Visits Involving Pharmaceutical Misuse 

and Abuse by Older Adults

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

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

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

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

DAWN Report:

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

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

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

made by persons aged 70 or older 

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

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

antidepressants (8.6 percent) 

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

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

hospital 

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

CO-OCCURRING SUBSTANCE USE AND MENTAL DISORDERS

Older Adults in Region 2 in SUD Treatment With Co-Occurring Mental 

Disorders

The national literature shows a strong 

relationship between substance use 

and mental disorders. Studies show 

that 30–80 percent of individuals with 

a substance use or mental disorder 

also have a co-occurring disorder.

TEDS data for the U.S. Virgin Islands 

in 2012 are unavailable. Therefore, 

Exhibit 11 shows regional and national 

figures only.

Exhibit 11. SUD Treatment Admissions of Adults Ages 50+ 

With a Co-Occurring Mental Disorder in Region 2 and the 

United States, 2012

Source: TEDS, 2012

Data include only those clients reported to SAMHSA.
Alabama ALABAMA Profile 2015 U.S. Virgin Islands U.S. Virgin Islands Profile 2016

7

MENTAL HEALTH

Older Adults in Region 2 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).

Recent BRFSS data for the U.S. Virgin 

Islands were unavailable. Therefore, data 

for Region 2 are used instead. Exhibit 12 

shows that older adults in Region 2 

experience FMD at a rate that is roughly 

similar to the national rate.

Exhibit 12. Individuals Reporting Frequent Mental 

Distress in Region 2 and the United States, 2013

Source: BRFSS, 2013

Older Adults in Region 2 Reporting Frequent Mental Distress by Age Group 

and Sex

Older men in Region 2 were more likely 

to indulge in binge drinking, but older 

women were more likely to report that 

they had FMD (14 days or more per 

30-day period). As Exhibit 13 shows, 

15.4 percent of women in the 50–64 age 

group and 8.4 percent in the 65+ age 

group reported FMD, while 10.7 percent 

of men in the 50–64 age group and 

5.9 percent in the 65+ age group 

reported FMD.

Exhibit 13. Individuals in Region 2 Reporting Frequent 

Mental Distress by Age Group and Sex, 2013

Source: BRFSS, 2013
8

U.S. Virgin Islands U.S. Virgin Islands 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 U.S. Virgin Islanders.

Exhibit 14. BRFSS Measures, 2010

Indicator Ages 50+ Ages 50–64 Ages 65+

Rarely or never get social 

or emotional support 14.6% 13.5% 16.9%

Dissatisfied or very 

dissatisfied 4.8% 5.5% 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

Source: BRFSS, 2013
Alabama ALABAMA Profile 2015 U.S. Virgin Islands U.S. Virgin Islands 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

Proportion Reporting Health Problems by Mental Health Category

Frequent mental distress Some or no mental distress

Source: BRFSS, 2013

Older U.S. Virgin Islanders Admitted to Territory Mental Health Services

Approximately 8.1 percent of the people served by the U.S. Virgin Islands mental health system were ages 

65 and older. This represents more than 40 adults.

Source: Center for Mental Health Services (CMHS) Uniform Reporting System (URS) Output Tables, 2013
10 U.S. Virgin Islands U.S. Virgin Islands 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 and territories 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 and territories 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.