Findings Health Outcomes | 2024 Senior Report

Executive Brief Introduction National HighlightsFindingsHealth Outcomes Social and Economic Factors Physical Environment Clinical Care State RankingsAppendixMeasures Table Data Source Descriptions MethodologyState Summaries

US Summary

2024 Senior Report 2024 Senior Report – Executive Brief 2024 Senior Report – State Summaries 2024 Senior Report – Risk of Social Isolation County-Level Maps 2024 Senior Report – Measures Table 2024 Senior Report – Infographics 2024 Senior Report – Report Data (All States)

Older adults in the U.S. had higher rates of high-speed internet and geriatric clinicians in this year’s report. The early death rate improved for the first time since 2019. However, older adults also struggled economically, as rates of poverty, food insecurity and housing costs rose.
Mortality
For the first time since the pandemic began, the death rate among adults ages 65-74 improved.
Early Death
Based on 2022 calculations, the average 65-year-old in the U.S. should expect to live another 18.9 years. However, many older adults do not live to see their 75th birthday. Individual- and community-level poverty, income inequality, racial segregation and low social support are all associated with increased risk of death in adults age 65 and older. Social isolation, which affects about one-quarter of older adults, also increases the risk of premature death. Research estimates that 48% of all premature deaths are because of behavioral and other preventable causes. 
Changes over time. Nationally, the rate of early deaths significantly decreased 8% between 2021 and 2022, from 2,151 to 1,979 deaths per 100,000 adults ages 65-74 — still higher than the rate in 2019 (1,765). In 2022, there were 668,581 deaths among adults ages 65-74, 55,685 fewer than in 2021. 
Between 2021 and 2022, the early death rate significantly decreased in 33 states, led by: 15% in Wyoming (2,299 to 1,948), 14% in Texas (2,439 to 2,106), and 12% in Alabama (2,928 to 2,581), Arizona (2,220 to 1,947), Florida (2,027 to 1,792), Idaho (1,971 to 1,740) and Montana (1,980 to 1,751). During this time, the rate significantly decreased among all racial/ethnic and gender groups. The largest decreases were: 20% among Hispanic (1,894 to 1,523), 16% among American Indian/Alaska Native (2,613 to 2,198) and 13% among Hawaiian/Pacific Islander (2,666 to 2,323) older adults. 
Disparities. In 2022, the early death rate significantly varied by race/ethnicity, geography and gender. The rate among adults ages 65-74 was:
2.9 times higher among Black (2,791 deaths per 100,000 adults ages 65-74) than Asian (963) older adults.*
1.9 times higher in Mississippi (2,847) than Hawaii (1,538).
1.5 times higher among men (2,420) than women (1,586).
Behavioral Health
Drug deaths and frequent mental distress among older Americans reached their highest levels in Senior Report history. The prevalence of depression among older adults also increased.
Drug Deaths
Drug overdoses are one of the leading causes of injury death in the U.S. and have skyrocketed in the last 20 years, severely impacting families and communities and placing an enormous burden on the health care system. Drug abuse is especially dangerous for older adults because age-related changes in the liver reduce the ability to metabolize medications, and most older adults take one or more prescription medications. Clinical strategies to prevent overdose deaths and reduce harm among older adults with opioid addiction include promoting non-medication pain management techniques, regularly reviewing older adults’ medication lists to avoid adverse drug events and following the CDC Clinical Practice Guideline for Prescribing Opioids for Pain. 
Changes over time. Nationally, the number of deaths due to drug injury (unintentional, suicide, homicide or undetermined) per 100,000 adults age 65 and older significantly increased 51% from 7.6 to 11.5 between 2017-2019 and 2020-2022. While drug deaths among older adults are below the Healthy People 2030 target to reduce drug overdose deaths to 20.7 per 100,000 population, the increase is concerning.
In 2020-2022, there were 19,516 drug deaths among adults age 65 and older, 7,546 more than in 2017-2019. Between 2017-2019 and 2020-2022, the drug death rate significantly increased in 34 states and the District of Columbia, led by: 157% in Delaware (6.1 to 15.7), 120% in the District of Columbia (40.6 to 89.4), 86% in Connecticut (8.3 to 15.4), and 84% in both South Carolina (6.8 to 12.5) and Kentucky (6.8 to 12.5). During this time, the rate also significantly increased 69% among men (10.1 to 17.1) and 25% among women (5.6 to 7.0) age 65 and older.
Disparities. In 2020-2022, the drug death rate significantly varied by race/ethnicity, geography and gender. The rate among adults age 65 and older was:
11.8 times higher among Black (30.8 deaths per 100,000 adults age 65 and older) than Asian (2.6) older adults.
21.8 times higher in the District of Columbia (89.4), and 4.6 times higher in Nevada (18.7), than in Nebraska (4.1).
2.4 times higher among men (17.1) than women (7.0).

Depression
Depression, also called major depressive disorder or clinical depression, is a common mood disorder that can negatively impact health. Risk factors for depression among older adults include loneliness, isolation, loss of loved ones, financial hardship, fear of death or dying, chronic health problems and a reduced sense of purpose brought on by major life changes such as retirement. The CDC’s Program to Encourage Active, Rewarding Lives (PEARLS) aims to reduce symptoms of depression and improve quality of life in older adults and has been implemented in 18 states so far.
Changes over time. Nationally, the percentage of adults age 65 and older who reported being told by a health professional that they have a depressive disorder (including depression, major depression, minor depression or dysthymia) significantly increased 6% from 14.6% to 15.5% between 2021 and 2022. More than 9.3 million older adults experienced depression in 2022. Between 2021 and 2022, the prevalence of depression significantly increased 29% in Georgia (11.4% to 14.7%) and 8% among women age 65 and older (17.6% to 19.0%).
Disparities. In 2022, depression significantly varied by disability status, race/ethnicity, geography, income, gender, sexual orientation, education and veteran status. The prevalence among adults age 65 and older was:
4.7 times higher among older adults who have difficulty with cognition (44.3%) than those without a disability (9.5%). 
3.4 times higher among multiracial (24.9%) than Asian (7.4%) older adults.**
2.3 times higher in Tennessee (22.4%) than Nebraska (9.8%).
1.8 times higher among older adults with household incomes less than $25,000 (22.4%) compared with those with incomes of $75,000 or more (12.3%).
1.7 times higher among women (19.0%) than men (11.1%).
1.6 times higher among LGBQ+ (24.0%) than straight (15.4%) older adults.
1.4 times higher among older adults with less than a high school education (18.9%) than those with a college degree (13.6%).**
1.2 times higher among older adults who have not served (16.0%) compared with those who have served (13.1%) in the U.S. armed forces.

Frequent Mental Distress
Frequent mental distress aims to capture the population experiencing persistent and likely severe mental health issues, defined by 14 or more days of self-reported poor mental health in the past month. Older adults are more likely to struggle with poor physical health and lack of access to quality health care, putting them at risk for mental health issues.
Changes over time. Nationally, the percentage of adults age 65 and older who reported their mental health was not good 14 or more days in the past 30 days significantly increased 11% from 8.5% to 9.4% between 2021 and 2022, reaching its highest level in Senior Report history. More than 5.5 million older adults experienced frequent mental distress in 2022. Between 2021 and 2022, the prevalence of frequent mental distress significantly increased 33% among older adults with household incomes of $50,000-$74,999 (5.7% to 7.6%) and 17% among those with a high school degree (8.7% to 10.2%).
Disparities. In 2022, frequent mental distress significantly varied by disability status, income, geography, education, race/ethnicity, sexual orientation and gender. The prevalence among adults age 65 and older was:
7.7 times higher among older adults who have difficulty with cognition (33.2%) compared with those without a disability (4.3%).***
2.9 times higher among older adults with household incomes less than $25,000 (15.8%) compared with those with incomes of $75,000 or more (5.5%).
2.4 times higher in Louisiana (12.7%) than South Dakota (5.3%).
2.3 times higher among older adults with less than a high school education (14.6%) compared with those with a college degree (6.3%).
2.2 times higher among American Indian/Alaska Native (16.5%) than Asian (7.4%) older adults.***
1.5 times higher among LGBQ+ (12.8%) than straight (8.8%) older adults.
1.4 times higher among women (10.8%) than men (7.7%). 
Physical Health
 The percentage of older adults who have had all their teeth removed due to decay or disease continued to improve but remained higher than the national Healthy People 2030 target.
Teeth Extractions
Complete tooth loss, also known as edentulism, is considered the “ultimate marker of disease burden for oral health.” The most common causes of complete tooth loss are tooth decay and gum disease, which become more likely with age. Having all or some permanent teeth missing is associated with an increased risk of loneliness, isolation, disability, mortality, and reduced daily function and quality of life among older adults. 
Changes over time. Nationally, the percentage of adults age 65 and older who reported having all teeth removed due to decay or gum disease significantly decreased 10% from 13.4% to 12.1% between 2020 and 2022. Despite this success, the national rate among adults age 65 and older remains above the Healthy People 2030 target of 5.4% for adults age 45 and older.
In 2022, more than 6.9 million older adults had no natural teeth remaining. Between 2020 and 2022, the prevalence of teeth extractions significantly decreased 42% in Illinois (14.9% to 8.7%). During this time, the prevalence also significantly decreased 13% among women (13.4% to 11.6%) and 10% among metropolitan residents (12.3% to 11.1%) age 65 and older. 
Disparities. In 2022, teeth extractions significantly varied by education, income, geography, race/ethnicity, disability status, metropolitan status and veteran status. The prevalence among adults age 65 and older was:
7.9 times higher among older adults with less than a high school education (28.4%) compared with those with a college degree (3.6%).
5.5 times higher among older adults with household incomes less than $25,000 (23.3%) compared with those with incomes of $75,000 or more (4.2%).
4.7 times higher in West Virginia (25.2%) than Hawaii (5.4%).
3.6 times higher among American Indian/Alaska Native (23.1%) than Asian (6.4%) older adults.****
3.1 times higher among older adults who have difficulty with self-care (24.1%) compared with those without a disability (7.9%).
1.5 times higher among non-metropolitan (17.2%) than metropolitan (11.1%) residents.
1.3 times higher among older adults who have served (15.0%) compared with those who have not served (11.5%) in the U.S. armed forces.

*The values for Asian and multiracial older adults may not be statistically different based on non-overlapping 95% confidence intervals.
**The values for multiracial, American Indian/Alaska Native and Hawaiian/Pacific Islander older adults may not be statistically different based on non-overlapping 95% confidence intervals; the same is true for Asian and Hawaiian/Pacific Islander older adults. The values for older adults with less than a high school education and those with some post-high school education may also not be statistically different based on non-overlapping 95% confidence intervals; the same is true for older adults with a college degree and those with a high school degree.
***The values for older adults who have difficulty with cognition and those who have difficulty with self-care may not be statistically different based on non-overlapping 95% confidence intervals. The values for American Indian/Alaska Native, multiracial, Hispanic and Black older adults may also not be statistically different based on non-overlapping 95% confidence intervals; the same is true for the values for Asian, white, Black and Hispanic older adults.
****The values for American Indian/Alaska Native, Black and multiracial older adults may not be statistically different based on non-overlapping 95% confidence intervals.