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Mental health among older, low-income adults in the U.S. is getting worse

A survey of Americans' well-being shows that seniors with low incomes are reporting worse mental health while their physical health is stable.

Since the turn of the millennium, the self-reported mental health of U.S. residents over 60 living off less than $35,000 a year has worsened, Stanford researchers have found.

David Rehkopf, ScD, MPH, associate professor of primary care and population health, said the finding was unexpected. "There's been a lot of attention paid to the decline of the 35- to 60-year-old cohort," he said. "We thought the 60-plus group was doing fine."

For the article published in JAMA Network Open, the researchers combed through data collected by the Centers for Disease Control. Every year, the CDC surveys Americans in all 50 states, asking basic questions about their physical and mental health and general well-being.

Rehkopf and his colleagues looked at survey results from 2003 to 2017, a sample size of almost 2.5 million people. Over that time, the 60-plus crowd has reported the same level of physical health. And seniors living off more than $35,000 a year have reported only a slight decline in their mental health.

"It's those people who have less than $35,000 a year who showed the biggest change," he said. He noted that most of the older people surveyed were retired and had a low annual income.

During the survey, respondents were asked, "Thinking about your mental health, which includes stress, depression and problems with emotions, for how many days during the past 30 days was your mental health not good?" Lower-income respondents who were older than 60 gave an average response of 2.9 days in 2003 and 4.1 days in 2017. Those without a high school diploma averaged 3.6 days in 2003 and 4.4 days in 2017.

As survey asks participants only general questions about well-being, Rehkopf said he and his colleagues weren't able to draw conclusions about why low-income seniors' mental health may be worsening.

But he speculated that economic forces affecting younger people may be affecting retirees as well. "Unemployment, job loss, social isolation -- those problems may stay with them and continue to affect mental health," he said. "Stress and anxiety don't stop just because they have retired."

Rehkopf said that the survey results show older Americans need more support, especially as people are expected to work longer, into their 60s and 70s. "It's a pretty unfair and unreasonable expectation to work more when people have health issues and a higher mental health burden," he said.

The researchers are currently evaluating whether seniors are doing better in some states than in others. "We want to see if there are policy changes that can be made at the state or local level that will help improve mental health," he said.

Photo by Pavlofox

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