BACKGROUND: It is projected that by 2020, 17% of North Carolinians will be 65 and older. Despite making up a significant proportion of the population, the elderly are often overlooked, particularly when it comes to their mental health and their use of substances like alcohol and other drugs. Better understanding the prevalence of substance dependence and suicide among the North Carolina (NC) elderly population can aid in identifying potential public health problems and lead to the development of targeted interventions.
METHODS: Data from the North Carolina Violent Death Reporting System (NC-VDRS) was used to determine suicide rates, method, and circumstances among NC residents ages 65 and older during the study period, 2010-2014. Rates for self-inflicted injury were calculated using hospital and emergency department data. Vital Records death certificate data were used to calculate rates of unintentional medication/drug deaths among the elderly. The Alcohol-Related Disease Impact (ARDI) tool was used to determine alcohol-related death rates and cause of death.
RESULTS: Elderly suicide rates increased with age, and rates were higher for males, and whites. The suicide rate for males 85 and older was 48.6 per 100,000 residents. Among both male and female older adults, firearms were the most frequently used suicide method. 6.4% of females and 8.4% of males who committed suicide had a documented alcohol problem. Alcohol-related death rates increased with age, and rates were higher for males, whites, and non-Hispanics. 8% of alcohol-related deaths among males were due to suicide; 2.4% of alcohol-related deaths among females were due to suicide. For both males and females falls injuries were the main alcohol-related cause of death. Unintentional medication/drug deaths among the elderly have increased from 1.9 per 100,000 in 2010 to 2.9 per 100,000 in 2014.
CONCLUSIONS: Suicide among young people often gets more attention, as does excessive drinking among young people. While these are important issues, our data show that suicide is a problem throughout the life course, as there are higher rates of suicide among the 65 and older population. Alcohol-related death rates are also high among the elderly, and unintentional medication/drug deaths have increased slightly since 2010. Developing mental health and substance dependence interventions targeting older adults should be a public health priority.