10/11/23, 9:03 AM The State of Mental Health and Aging in America
Issue Brief #1:
What Do the Data Tell Us? The State of Mental Health
In recognition of the essential role mental health
plays in overall health, the Healthy Aging Program
and Aging in America
at the Centers for Disease Control and Prevention
(CDC) and the National Association of Chronic
Disease Directors (NACDD) are releasing two issue
briefs focused on the mental health of older adults in
the United States.
This first issue brief reviews existing data and lays
the foundation for understanding key issues related
to mental health in adults over 50. The second brief
will focus on depression, an important and
emerging public health issue. Recent public health
efforts to develop, test, and disseminate programs
that address depression in older adults have led to
practical information on this topic; the second issue
brief will examine interventions to address
depression that communities can use to improve the
mental health and quality of life of older
Americans.
Why is Mental Health a Public Health Issue?
The World Health Organization defines health as “a state of complete physical,
mental, and social well-being and not merely the absence of disease or
infirmity” (1). Because mental health is essential to overall health and
well-being, it must be recognized and treated in all Americans, including older
adults, with the same urgency as physical health. For this reason, mental health
is becoming an increasingly important part of the public health mission. In fact,
the mental health of older Americans has been identified as a priority by the
Healthy People 2010 objectives (2), the 2005 White House Conference on
Aging (3), and the 1999 Surgeon General’s report on mental health (4).
The goals and traditions of public health and health promotion can be
applied just as usefully in the field of mental health as they have been in the
prevention of both infectious and chronic diseases. Public health agencies can
incorporate mental health promotion into chronic disease prevention efforts,
conduct surveillance and research to improve the mental health evidence base,
and collaborate with partners to develop comprehensive mental health plans and
to enhance coordination of care. The challenges for public health are to identify
risk factors, increase awareness about mental disorders and the effectiveness of
treatment, remove the stigma associated with mental disorders and receiving
treatment for them, eliminate health disparities, and improve access to mental
health services, particularly among populations that are
disproportionately affected (5).
The State ofMental Health
Mental Health Problems
and Aging in
in America Older Adults
It is estimated that 20% of people age 55 years or older experience some type of
mental health concern (6). The most common conditions include anxiety, severe
cognitive impairment, and mood disorders (such as depression or bipolar disorder) (6).
Mental health issues are often implicated as a factor in cases of suicide. Older men
have the highest suicide rate of any age group (7). Men aged 85 years or older have a
suicide rate of 45.23 per 100,000, compared to an overall rate of 11.01 per 100,000
The presence of depressive disorders for all ages (7).
often adversely affects the course
The Significance of Depression
and complicates the treatment Depression, a type of mood disorder, is the most prevalent mental health problem
of other chronic diseases ld d l d hd d ff (4) l l d
about:blank 1/13
, 10/11/23, 9:03 AM The State of Mental Health and Aging in America
p y gp p
disproportionately affected (5).
The State ofMental Health
Mental Health Problems
and Aging in
in America Older Adults
It is estimated that 20% of people age 55 years or older experience some type of
mental health concern (6). The most common conditions include anxiety, severe
cognitive impairment, and mood disorders (such as depression or bipolar disorder) (6).
Mental health issues are often implicated as a factor in cases of suicide. Older men
have the highest suicide rate of any age group (7). Men aged 85 years or older have a
suicide rate of 45.23 per 100,000, compared to an overall rate of 11.01 per 100,000
The presence of depressive disorders for all ages (7).
often adversely affects the course
The Significance of Depression
and complicates the treatment Depression, a type of mood disorder, is the most prevalent mental health problem
of other chronic diseases. among older adults. It is associated with distress and suffering (4). It also can lead to
impairments in physical, mental, and social functioning (4). The presence of
depressive disorders often adversely affects the course and complicates
the treatment of other chronic diseases (8). Older adults with
depression visit the doctor and emergency room more often, use more
medication, incur higher outpatient charges, and stay longer in the
hospital (4).
Although the rate of older adults with depressive symptoms tends to
increase with age (4), depression is not a normal part of growing older.
Rather, in 80% of cases it is a treatable condition (8). Unfortunately,
depressive disorders are a widely under-recognized condition and often
are untreated or undertreated among older adults (4).
The Behavioral Risk Factor Surveillance
System and Indicators
As described earlier, a core public health function related to mental health is the col-
lection of surveillance data that can be used for priority setting and as the foundation
for developing public health programs.
Through CDC’s Behavioral Risk Factor Surveillance System (BRFSS—see
Technical Information), states collect data on the mental health of older adults. The
BRFSS questionnaire consists of three parts: 1) core questions asked to all 50 states,
the District of Columbia and three territories, 2) supplemental modules which are
a series of questions on specific topics (e.g. mental health, adult asthma history, inti-
mate partner violence), and 3) state-added questions that are selected by individual
states.
Unfortunately, depressive disorders
are a widely under-recognized condition There are BRFSS core questions related to mental health that collect information on
and often are untreated or under-treated the prevalence of social and emotional support, life satisfaction, and the number of
mentally unhealthy days.
among older adults. An Anxiety and Depression module was developed for the BRFSS to collect
additional information on mental health conditions. In 2006, 38 states and three
territories used this module to determine the prevalence of current depression, life-
time diagnosis of depression, and lifetime diagnosis of anxiety.
This issue brief reports on six indicators related to mental health that were part of
the 2006 BRFSS survey, both from core questions and the Anxiety and Depression
module. Data are provided for the U.S. population age 50 years or older, with a
focus on age, racial/ethnic differences, and sex.
Page 2 The State of Mental Health and Aging in America
Social and Emotional Support
Percentage of adults aged 50 or older
who reported that they ‘rarely’ or ‘never’
received the social support that they
needed
0 - 7.87% 9.42 - 11.18%
about:blank 2/13
Issue Brief #1:
What Do the Data Tell Us? The State of Mental Health
In recognition of the essential role mental health
plays in overall health, the Healthy Aging Program
and Aging in America
at the Centers for Disease Control and Prevention
(CDC) and the National Association of Chronic
Disease Directors (NACDD) are releasing two issue
briefs focused on the mental health of older adults in
the United States.
This first issue brief reviews existing data and lays
the foundation for understanding key issues related
to mental health in adults over 50. The second brief
will focus on depression, an important and
emerging public health issue. Recent public health
efforts to develop, test, and disseminate programs
that address depression in older adults have led to
practical information on this topic; the second issue
brief will examine interventions to address
depression that communities can use to improve the
mental health and quality of life of older
Americans.
Why is Mental Health a Public Health Issue?
The World Health Organization defines health as “a state of complete physical,
mental, and social well-being and not merely the absence of disease or
infirmity” (1). Because mental health is essential to overall health and
well-being, it must be recognized and treated in all Americans, including older
adults, with the same urgency as physical health. For this reason, mental health
is becoming an increasingly important part of the public health mission. In fact,
the mental health of older Americans has been identified as a priority by the
Healthy People 2010 objectives (2), the 2005 White House Conference on
Aging (3), and the 1999 Surgeon General’s report on mental health (4).
The goals and traditions of public health and health promotion can be
applied just as usefully in the field of mental health as they have been in the
prevention of both infectious and chronic diseases. Public health agencies can
incorporate mental health promotion into chronic disease prevention efforts,
conduct surveillance and research to improve the mental health evidence base,
and collaborate with partners to develop comprehensive mental health plans and
to enhance coordination of care. The challenges for public health are to identify
risk factors, increase awareness about mental disorders and the effectiveness of
treatment, remove the stigma associated with mental disorders and receiving
treatment for them, eliminate health disparities, and improve access to mental
health services, particularly among populations that are
disproportionately affected (5).
The State ofMental Health
Mental Health Problems
and Aging in
in America Older Adults
It is estimated that 20% of people age 55 years or older experience some type of
mental health concern (6). The most common conditions include anxiety, severe
cognitive impairment, and mood disorders (such as depression or bipolar disorder) (6).
Mental health issues are often implicated as a factor in cases of suicide. Older men
have the highest suicide rate of any age group (7). Men aged 85 years or older have a
suicide rate of 45.23 per 100,000, compared to an overall rate of 11.01 per 100,000
The presence of depressive disorders for all ages (7).
often adversely affects the course
The Significance of Depression
and complicates the treatment Depression, a type of mood disorder, is the most prevalent mental health problem
of other chronic diseases ld d l d hd d ff (4) l l d
about:blank 1/13
, 10/11/23, 9:03 AM The State of Mental Health and Aging in America
p y gp p
disproportionately affected (5).
The State ofMental Health
Mental Health Problems
and Aging in
in America Older Adults
It is estimated that 20% of people age 55 years or older experience some type of
mental health concern (6). The most common conditions include anxiety, severe
cognitive impairment, and mood disorders (such as depression or bipolar disorder) (6).
Mental health issues are often implicated as a factor in cases of suicide. Older men
have the highest suicide rate of any age group (7). Men aged 85 years or older have a
suicide rate of 45.23 per 100,000, compared to an overall rate of 11.01 per 100,000
The presence of depressive disorders for all ages (7).
often adversely affects the course
The Significance of Depression
and complicates the treatment Depression, a type of mood disorder, is the most prevalent mental health problem
of other chronic diseases. among older adults. It is associated with distress and suffering (4). It also can lead to
impairments in physical, mental, and social functioning (4). The presence of
depressive disorders often adversely affects the course and complicates
the treatment of other chronic diseases (8). Older adults with
depression visit the doctor and emergency room more often, use more
medication, incur higher outpatient charges, and stay longer in the
hospital (4).
Although the rate of older adults with depressive symptoms tends to
increase with age (4), depression is not a normal part of growing older.
Rather, in 80% of cases it is a treatable condition (8). Unfortunately,
depressive disorders are a widely under-recognized condition and often
are untreated or undertreated among older adults (4).
The Behavioral Risk Factor Surveillance
System and Indicators
As described earlier, a core public health function related to mental health is the col-
lection of surveillance data that can be used for priority setting and as the foundation
for developing public health programs.
Through CDC’s Behavioral Risk Factor Surveillance System (BRFSS—see
Technical Information), states collect data on the mental health of older adults. The
BRFSS questionnaire consists of three parts: 1) core questions asked to all 50 states,
the District of Columbia and three territories, 2) supplemental modules which are
a series of questions on specific topics (e.g. mental health, adult asthma history, inti-
mate partner violence), and 3) state-added questions that are selected by individual
states.
Unfortunately, depressive disorders
are a widely under-recognized condition There are BRFSS core questions related to mental health that collect information on
and often are untreated or under-treated the prevalence of social and emotional support, life satisfaction, and the number of
mentally unhealthy days.
among older adults. An Anxiety and Depression module was developed for the BRFSS to collect
additional information on mental health conditions. In 2006, 38 states and three
territories used this module to determine the prevalence of current depression, life-
time diagnosis of depression, and lifetime diagnosis of anxiety.
This issue brief reports on six indicators related to mental health that were part of
the 2006 BRFSS survey, both from core questions and the Anxiety and Depression
module. Data are provided for the U.S. population age 50 years or older, with a
focus on age, racial/ethnic differences, and sex.
Page 2 The State of Mental Health and Aging in America
Social and Emotional Support
Percentage of adults aged 50 or older
who reported that they ‘rarely’ or ‘never’
received the social support that they
needed
0 - 7.87% 9.42 - 11.18%
about:blank 2/13
