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 Researchers examined data on 2.4 million people aged 60 and older
who participated in annual surveys between 2003 and 2017, answering
questions about their general health and the number of days they
experienced poor physical or mental health. Overall, 41% had
household income of no more than $35,000 a year and 10% lacked a
high school education.
During the study, the average number of days each month when people
aged 60 to 64 experienced poor mental health rose from 2.9 to 3.6.
That number climbed from 2.3 to 3.0 days for individuals 65 to 69
and from 2.2 to 2.4 days among those 70 to 74 years old.
Declines in mental health were similar for men and women, but
greater for people with lower income and education, researchers
report in JAMA Network Open.
Among those with annual household income of $35,000 or less, the
average monthly number of poor mental health days rose from 2.9 to
4.1. When the head of the household lacked a high school diploma,
the number of poor mental health days increased from 3.6 to 4.4.
"Individuals with lower income and lower levels of education not
only lack access to mental health services, but also are on average
exposed to more stressful working conditions, lower job security and
they have less money to buy health promoting goods," said lead
researcher David Rehkopf of Stanford University School of Medicine
in California.
"When someone has less resources to meet basic needs, taking care of
mental health often is by necessity secondary," Rehkopf said by
email. "Research finds that time and time again when basic needs are
met, people are able to do more to take care of themselves, which
includes their own mental health."
While previous research has documented recent declines in mental and
physical health and increases in mortality rates among adults in
their prime working years, the trends for older adults and retirees
haven't been as clear, Rehkopf and colleagues write.
In the current study, general and physical health improved or were
stable for all groups aged 65 and older.
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For example, the proportion of people ages 65 to 69 who reported
"fair" or "poor" general health dropped from 23% to 19% during the
study period. People this age reported an average of 4.9 days of
poor physical health in both 2003 and 2017.
Among those 60 to 64 years old, the proportion of people reporting
"poor" or "fair" general health held steady at about 23%, while the
average number of days with physical health issues climbed slightly
from 5.0 to 5.4 a month.
One limitation of the study is that researchers lacked data from
health records to verify any diagnosed physical or mental illness.
Other drawbacks include the lack of information on any cognitive or
memory problems, or on older adults living in nursing homes or other
institutional settings.
Even so, "these trends suggest a toxic mix of rising economic
uncertainty and poorer access to quality mental health care among
elders in the U.S.," said Benjamin Le Cook, director of the Health
Equity Research Lab at Cambridge Health Alliance in Massachusetts.
"The greater declines among elders in lower income and education
categories are related to worsening stress, anxiety and depression
among groups in the U.S. that have faced stagnation in wages before
retirement, uncertain benefits and income after retirement,
continued obstacles to stable housing, and high medical costs as a
percentage of income," Cook, who wasn't involved in the study, said
by email.
"Furthermore, access to quality mental health care is only available
to less than half of the population with serious mental illness and
access is even worse for the elderly, low-income and the uninsured,"
Cook added.
SOURCE: https://bit.ly/2QkIvf9 JAMA Network Open, online December
18, 2019.
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