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Challenges

  • Since the 2014 edition, suicide among adults aged 65+ increased 12 percent from 14.8 to 16.6 deaths per 100,000.
  • Since the 2014 edition, falls increased 4 percent from 28.4 percent to 29.5 percent of adults aged 65+.
  • In the past year, flu vaccination coverage significantly decreased 3 percent from 60.7 percent to 58.8 percent of adults aged 65+.
  • Since the 2013 edition, obesity increased 11 percent from 25.3 percent to 28.0 percent of adults aged 65+.

Suicide Increasing, Varies by State

Since the 2014 edition, the number of deaths due to intentional self-harm per 100,000 adults aged 65 and older increased 12 percent from 14.8 to 16.6 deaths per 100,000 adults. The largest decrease in suicide since 2014 occurred in Alaska, from 22.8 to 14.1 deaths per 100,000 (Figure 18). In this same period, the suicide rate among seniors increased by five or more deaths per 100,000 adults aged 65 and older in:
  • Wyoming from 24.3 to 31.5
  • New Mexico from 21.8 to 28.6
  • Utah from 15.7 to 21.3
  • West Virginia from 16.9 to 22.3
  • Oklahoma from 15.8 to 21.0
The differences in suicide incidence between states are striking (Figure 19). Suicide among seniors is 3.9 times higher in Nevada (32.3 deaths per 100,000 adults aged 65 and older) than in Massachusetts (8.3 deaths per 100,000). Wyoming (31.5 deaths per 100,000), New Mexico (28.6 deaths per 100,000), Montana (25.5 deaths per 100,000) and Oregon (25.1 deaths per 100,000) have suicide rates greater than 25.0 deaths per 100,000 adults aged 65 and older.

Falls Rising, Prevalence Differs

Since the 2014 edition, the percentage of adults aged 65 and older who reported having fallen in the previous 12 months increased 9 percent from 27.1 percent to 29.5 percent. No state showed notable decreases in the past four years (Figure 20), but falls increased significantly in:
  • Colorado from 27.4 to 31.0 percent
  • Louisiana from 24.1 to 31.0 percent
  • Maryland from 23.4 to 28.6 percent
  • Michigan from 16.2 to 28.9 percent
  • Oregon from 18.4 to 32.4 percent
  • Wisconsin from 14.5 to 28.0 percent
The prevalence of falls differs by gender, race/ethnicity, urbanicity and income.
Falls are more prevalent among:
  • Women (31.5 percent) aged 65 and older than men (27.1 percent)
  • American Indian/Alaskan Native (34.7 percent) and white (30.6 percent) seniors compared with Asian (20.3 percent), black (23.6 percent) and Hispanic (26.9 percent) seniors
  • Rural (32.4 percent) seniors compared with suburban (28.5 percent) and urban (29.5 percent) seniors (See Disparities in Rural Health)
  • Seniors in the lowest income level (less than $25,000/year) at 32.9 percent compared with seniors in all other income levels

Obesity Continues Rising, Large Disparities Exist

Since the 2013 edition, the percentage of adults aged 65 and older with a body mass index of 30.0 or higher based on reported height and weight increased 11 percent from 25.3 percent to 28.0 percent. In the past five years, the prevalence of seniors with obesity increased significantly in nine states (Figure 21), notably:
  • North Dakota from 24.4 to 32.1 percent
  • Wisconsin from 26.9 to 34.6 percent
  • Nevada from 18.1 to 25.7 percent
  • Louisiana from 28.7 to 35.3 percent
No states had remarkable decreases in the past five years.
Differences in obesity prevalence exist by race/ethnicity, urbanicity, education and income. Obesity prevalence is significantly higher among:
  • American Indian/Alaskan Native (35.3 percent), black (36.5 percent) and Hispanic (32.8 percent) seniors than among white (27.2 percent) seniors; Asian seniors have the lowest obesity prevalence at 11.8 percent, significantly lower than white seniors.
  • Rural seniors (29.2 percent) have a higher prevalence than suburban (27.2 percent) and urban (26.6 percent) seniors (see Disparities in Rural Health)
  • Seniors with less than a high school education (33.3 percent), high school graduates (29.9 percent) or some college (29.1 percent) have a higher prevalence than college graduates (21.9 percent)
  • Seniors with annual incomes less than $25,000 (32.3 percent), $25,000 to $49,999 (29.2 percent) or $50,000 to $74,999 (29.1 percent) have a higher prevalence than those with an annual household income of $75,000 or more (23.6 percent)

Flu Vaccination Coverage Declining

Since the 2017 edition, the percentage of adults aged 65 and older who reported receiving a flu vaccine in the past year decreased 3 percent from 60.7 percent to 58.8 percent. In this same period flu vaccination coverage increased significantly only in Florida (Figure 22) from 51.4 percent to 57.6 percent of adults aged 65 and older and decreased significantly in eight states, notably in:
  • Kansas from 61.7 to 54.8 percent
  • Louisiana from 59.1 to 51.6 percent
  • Kentucky from 67.3 to 59.4 percent
  • Texas from 66.3 to 57.3 percent
The percentage of seniors who reported receiving a flu vaccination in the past year varies by race/ethnicity, urbanicity and education. Flu vaccination coverage is lower among:
  • Black seniors at 49.4 percent compared with Asian (61.2 percent), Hawaiian/Pacific Islander (68.1 percent), Hispanic (56.0 percent) and white (60.3 percent) seniors
  • Rural seniors (57.2 percent) versus urban (61.4 percent), but not suburban (59.1 percent) seniors (see Disparities in Rural Health)
  • Seniors with less than a high school education (56.5 percent), high school graduates (56.8 percent) or some college (58.1 percent) compared with college graduates (63.7 percent)

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