​Older Americans Face Mental Health Issues, Opioid Deaths​​

The report was based on 21 sources, including the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System and the Center for Medicare and Medicaid Services’ Mapping Medicare Disparities Tool. It examined 62 measures across five categories of health: health outcomes, social and economic factors, physical environment, behaviors and clinical care.

“These have always been issues but have most likely worsened because of the COVID-19 pandemic,” says Rhonda Randall, D.O., executive vice president and chief medical officer of United Healthcare Employer and Individual. “It’s really a call to action for our communities and our public health officials.”

Here are some of the top highlights as well as advice from Randall, who is also a geriatrician, on what can be done to effect change.

Premature-death rates are rising. A decade of progress lowering early-death rates among older adults has been derailed. There was a 17 percent increase in early-death rates between 2019 and 2020, largely due to the pandemic. “That’s the greatest increase we’ve ever seen,” says Randall, who notes that about two-thirds of those representing those increases had a COVID-19 diagnosis on their death certificate. Older Americans of color experienced the greatest spikes: Hispanics saw a 48 percent increase in death rates, and Blacks, Asians and American Indians saw their rates go up by about roughly a third. The early-death rate in 2020 was 3.2 times higher among older Black adults ages 64 to 75 than older multiracial adults.       

Drug deaths have doubled among older Americans. The COVID-19 pandemic isn’t enough to explain the increases in premature-death rates. Drug deaths play a huge part of this equation, Randall stresses. The rate of drug deaths doubled among Americans age 65 and older between 2008 and 2010 and 2018 and 2020, from 4.2 to 8.4 deaths per 100,000. “We lost an additional 8,620 seniors over a decade,” she says. While this change was seen across all age groups, it was most stark in those between the ages of 65 and 74: a 147 percent increase. Most of these deaths, she says, are due to older adults taking opioid medications that weren’t prescribed for them. This is alarming, especially since older people don’t metabolize medications as well because of age-related changes in their liver.

Many older adults say they’re healthier than ever. In 2020 about 20 million older Americans reported high health status, the highest seen in the past decade, Randall observes. Since 2011, there was a 13 percent increase in older people reporting that their health is very good or excellent, from 38.4 percent to 43.5 percent. Much of that improvement occurred in the past couple of years, rising from 41 percent in 2019 to 43.5 percent in 2020. This is surprising, given the rising death rate and death rate from drug overdoses, but it may be that those who are relatively healthy are feeling resilient. “Some of it is the sense of, hey, look at me, I came through the pandemic and I’m still alive and kicking,” Randall says. “But it may also be that seniors appreciate the ability to get care at home through telehealth, and the recognition that health care is more than just the 15 minutes they spend in a doctor’s office.”