259178 Substance use and health status among older adults: An examination of data from a local-level Behavioral Risk Factor Surveillance Survey (BRFSS)

Monday, October 29, 2012

Lisa Arsenault, PhD , Institute for Community Health, Cambridge Health Alliance, Cambridge, MA
Karen Hacker, MD MPH , Institute for Community Health, Cambridge Health Alliance, Cambridge, MA
Justeen Hyde, PhD , Institute for Community Health, Cambridge Health Alliance, Cambridge, MA
Lise Fried, DSc, MS , Institute for Community Health, Cambridge Health Alliance, Cambridge, MA
Background: National data show the proportion of older adults using illicit or non-medical prescription drugs is growing and the number with substance use disorders is projected to double by 2020. Chronic health conditions common to an aging population may coexist with substance use, however few studies have examined associations between health status and substance use in older adults. This analysis used local-level BRFSS data to explore associations between substance use and indicators of health status among older adults. Methods: The 2008 Five Cities in Massachusetts BRFSS was conducted in 5 communities neighboring Boston, MA. The survey was a stratified, random sample of telephone-equipped households. The survey included demographic, physical and mental health, and substance use questions. All analyses were weighted to account for the sampling scheme. Results: The final sample size (N=2,171) represented over 86,000 individuals ages 45 and older (57% female, 82% white, and 40% college graduates). Overall, 5.7% were categorized as users of illicit and/or non-medical prescription drugs (use in prior year). Use was more frequent among those ages 45-64 (8.5%) compared those ages 65+ (1.4%). Marijuana was the most commonly used illicit substance (4.3%) followed by prescription drugs (2.2%). Multivariate models indicated users were significantly more likely to report poor/fair health status, feeling depressed all/most of the time, and chronic health conditions including hypertension, high cholesterol, and asthma. Conclusions: Understanding the magnitude of this trend and the correlates of substance use among older adults will help improve treatment effectiveness and access for this age group.

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
1) Explain the methodology utilized in population based surveillance studies. 2) Describe the future challenge the aging US population presents to the field of substance abuse treatment. 3) Identify ways the knowledge of substance use among older adults can improve the health of this population.

Keywords: Elderly, Substance Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted and published primary research on older adult populations. I have been the lead analyst on the MA 5-city BRFSS since 2009. I have worked as an epidemiologist/analyst on several federally funded local program evaluations related to substance use and abuse in the Boston area. The health of older adult populations is one of my primary scientific interests.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.