Age- and Gender-Based Populations

Learn how SAMHSA’s programs, initiatives, and resources work to improve the behavioral health of age- and gender-based populations.

Gender and age are important factors to consider when examining patterns of behavioral health. Patterns of substance use vary by age, with these rates generally declining as people grow older.

Children, Youth, and Families

Improving access to behavioral health services for children, youth, and their families is one of SAMHSA’s core missions. Half of adult mental illness begins before the age of 14, and three-fourths before age 24. More than 40% of youth ages 13 to 17 have experienced a behavioral health problem by the time they reach seventh grade. In addition, suicide is the third leading cause of death among youth ages 15 to 24 after accidents and homicide.

Compared with their peers, people within this age group with mental disorders are more likely to experience homelessness, be arrested, drop out of school, and be underemployed. Compared to all other chronic health conditions, mental disorders produce the greatest disability impact within this age group.

Youth transitioning into adulthood have some of the highest rates of alcohol and substance abuse. For instance, rates of binge drinking (drinking five or more drinks on a single occasion) in 2014 were:

28.5% for people ages 18 to 20
43.3% for people ages 21 to 25

Learn more about SAMHSA programs that address underage drinking at the Underage Drinking topic.

An estimated 1.3 million U.S. adolescents ages 12 to 17 had a substance use disorder in 2014 (5% of all adolescents). The 2014 rate of past-month illicit drug use was 3.4% among those ages 12 to 13, 7.9% among youth ages 14 to 15, and 16.5% among youth ages 16 to 17. The highest rate of current illicit drug use was among youth ages 18 to 20 (22.7%), with the next highest rate occurring among people ages 21 to 25 (21.5%).

Adolescents and young adults also face challenges with mental health issues:

In 2014, about 1 in 10 youth ages 12 to 17 (11.4%) had a major depressive episode (MDE) in the past year. Among adolescents with MDE, 41.2% received treatment or counseling for depression in the past year.
Combined 2010–2012 data from SAMHSA’s National Survey on Drug Use and Health (NSDUH) indicate that 1 in 5 young adults ages 18 to 25 (18.7%) reported a mental illness in the past year and 3.9% were diagnosed with a serious mental illness.
In 2014, 1.4% of adolescents had a co-occurring MDE and a substance use disorder.

Children and youth are viewed and understood in the context of their families, their communities, and their cultures. SAMHSA works to promote systems of care that involve parents in treatment planning and decisions for children:

Building Blocks for a Healthy Future is a website where parents, caregivers, and educators can find great tips and tools that help children make healthy decisions as they grow up.
National Children’s Mental Health Awareness Day raises awareness about the importance of emphasizing positive mental health as part of a child’s overall development from birth.
The Safe Schools/Healthy Students initiative is a program designed to prevent violence and substance abuse among our nation's youth, schools, and communities.

Men and Women

In 2012, there were about 154.5 million men (of all ages) living in the United States compared to about 159.4 million women (of all ages). The percentage of men under the age of 65 without health insurance in 2011 was 18.5%. The rate for women was 15.4%.

Data from the 2014 NSDUH (PDF | 3.4 MB) shows that rates of substance use disorders differ between men and women. For instance:

The percentage of women ages 18 and up who had five or more drinks in one day at least once in the past year was 17.4%. The percentage was higher for men in this age group at 32.6%.
Men aged 12 or older are more likely than women to report illegal drug use (12.8% vs. 7.3%).
More men than women ages 12 and up reported using marijuana (9.7% vs. 5.6%), cocaine (0.8% vs. 6%), and hallucinogens (0.6% vs. 0.3%).
The rate of substance dependence or abuse for males ages 12 and up was greater than the rate for females (10.7% vs. 5.7%).

Women’s drinking patterns are different from men’s. They face greater risks than men because:

Women typically start to have alcohol-related problems at lower drinking levels than men.
Women typically weigh less than men.
Pound for pound, women have less water in their bodies than men do, and alcohol resides predominantly in body water.

While women may have alcohol and substance abuse rates lower than men, women are more likely to have serious psychological distress than men. According to the 2014 NSDUH’s mental health findings (PDF | 3.4 MB), women aged 18 and older in 2014 were more likely than men to have serious mental illness in the past year (5% vs. 3.1%). Women between 2005 and 2008 made 29.4 million of the ambulatory care visits with a primary mental health diagnoses, compared with 18.5 million for men. However, in 2012, the percentage of adult males with a past-year co-occurring mental illness and substance use disorder was higher than that among adult females (3.6% vs. 3%). Learn more from SAMHSA’s Behavioral Health Barometer United States – 2014 (PDF | 3.9 MB) report for more point-in-time and trend data reflecting the behavioral health status of men and women in the United States.

Many of the programs and initiatives that SAMHSA offers women seek to address the barriers to mental health and substance abuse services they face compared to their male counterparts. Learn more about these programs and initiatives at the Health Disparities topic.

SAMHSA provides training and technical assistance addressing the behavioral health of women and their families at theWomen, Children, and Families webpage. SAMHSA also addresses the behavioral health needs of women who experience sexual and domestic violence. Learn more at the Trauma and Violence topic.

Older Adults

There are about 43.1 million people ages 65 and up living in the United States. This population group is expected to account for about 20% of the total U.S. population by 2030.

The prevalence of substance use disorders among older adults remains relatively constant until they reach the age of 60. After that, the rate of those disorders drops to about 6%.

Data from the 2014 NSDUH (PDF | 3.4 MB) highlights similar findings:

Only 25.8% of people ages 65 and up in 2014 had ever used illegal drugs in their lifetime, while the lifetime rates of use were 53.8% for those ages 60 to 64 and more than 50% for each age group from ages 19 to 59.
The prevalence of heavy alcohol use in 2014 was lower among adults ages 65 and up (2.2%) than among all other adult age groups.

Some aspects of mental health also improve with age. For example, in 2014, 13.0% of adults ages 65 or older had a form of mental illness while the rates were more than 17% for each age group from 18 to 64. In addition, 1.6% of adults aged 65 or older had serious thoughts of suicide in the past year, while the national average was 3.9%. However, many older adults still experience mental distress associated with limitations in daily activities, physical impairments, grief following loss of loved ones, caregiving or challenging living situations, or an untreated mental illness such as depression.

Depression affects more than 6.5 million Americans ages 65 and up. Depression in older adults is closely associated with substance abuse and disability. If left untreated, depression in this population increases the risks of cognitive decline and suicide.

About 25% of older adults have some type of mental health problem, such as a mood disorder not associated with normal aging. Older adults with mental disorders are less likely than those without them to be nonsmokers, to eat a healthy diet, or regularly engage in moderate physical activity.

Learn more from the Treatment of Depression in Older Adults KIT – 2011, which includes evidence-based practices.

Last Updated: 10/09/2015