Older Americans face mental health issues and opioid-related 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 in five health categories: health outcomes, social and economic factors, physical environment, behaviors and clinical care.

“These have always been issues, but they’ve most likely gotten worse due to the COVID-19 pandemic,” says Rhonda Randall, DO, executive vice president and chief medical officer of United Healthcare Employer and Individual. “This is truly a call to action for our communities and our public health officials.”

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

Premature mortality rates are rising. A decade of progress in reducing early death rates in the elderly has been derailed. There was a 17% increase in early death rates between 2019 and 2020, largely due to the pandemic. “This is the biggest increase we’ve ever seen,” says Randall, who notes that about two-thirds of those accounting for these increases had a diagnosis of COVID-19 on their death certificate. Older Americans of color saw the largest spikes: Hispanics saw their death rates increase by 48%, and Blacks, Asians and Native Americans saw their rates increase by about a third. The early death rate in 2020 was 3.2 times higher among black adults aged 64 to 75 than among older multiracial adults.

Drug deaths have doubled among older Americans. The COVID-19 pandemic is not enough to explain the increase in premature death rates. Drug-related deaths play an important role in this equation, Randall points out. The rate of drug-related deaths doubled among Americans ages 65 and older between 2008 and 2010 and 2018 and 2020, from 4.2 to 8.4 deaths per 100,000. “We lost 8,620 seniors more in a decade,” she says. While this change was seen across all age groups, it was most pronounced among those aged 65 to 74: a 147% increase. Most of these deaths, she says, are due to elderly people taking opioid medications that were not prescribed to them. This is alarming, especially since older people don’t metabolize drugs as well due to age-related changes in their livers.

Many seniors say they are healthier than ever. In 2020, about 20 million older Americans reported high health, the highest in a decade, Randall observes. Since 2011, the number of seniors reporting very good or excellent health has increased by 13%, from 38.4% to 43.5%. Much of this improvement has occurred over the past two years, rising from 41% in 2019 to 43.5% in 2020. This is surprising, given the increase in death rate and death rate from drug overdose, but those who are relatively healthy may feel resilient. “Part of it is the feeling of, hey, look at me, I’ve been through the pandemic and I’m still alive and kicking,” Randall says. “But older people may also appreciate the ability to get care at home through telehealth and the recognition that healthcare is more than the 15 minutes they spend in a doctor’s office.”

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