Manik Ahuja, Assistant Professor in the East Tennessee State University College of Public Health’s Department of Health Services Management and Policy, is lead author of an article in the Journal of Public Health Research. The article is titled, “Association between chronic disease and substance use among older adults in Tennessee.”
Co-authors include College of Public Health students Johanna Cimilluca, Kawther Al Skir, and Kathleen Baggett as well as Jessica Stamey in the ETSU College of Nursing, Mary K. Herndon and Praveen Fernandopulle of the ETSU Quillen College of Medicine, and Thiveya Sathiyasaleen of the Aureus School of Medicine.
Substance use and misuse have a negative impact on health care outcomes, specifically in the older adult population. Older adults are at risk due to several factors occurring toward the end of life such as changing family dynamics, loss of friends and loved ones, and chronic diseases. Substance use in older adults with chronic diseases in rural areas remains poorly studied. This study examines older adults greater than 55 of age in the state of Tennessee. Data was extracted from the 2019 National Behavioral Risk Factor Surveillance System (BRFSS) with a subsample for the State of Tennessee and individuals over age 55.
“The population of older adults in Tennessee is expected to increase by over 300,000 residents over the next decade. By 2030 it is expected that older adults will represent 25% of the state’s overall population,” said Dr. Ahuja. “It is essential that we further understand how older adults cope with their chronic conditions, as substance use is common among those burdened with chronic disease. Unfortunately, many use tobacco products, or other illicit substances, to cope with the stressors associated with chronic disease, which may worsen their condition."
The study found that at least 33.7% of older adults have a chronic disease, and 24.4% have at least two or more chronic diseases. Alcohol use in the past month was reported in 29.4% of older adults; however, chronic disease status was not associated with alcohol use. Marijuana use and tobacco smoking in the past month were significant for older adults with two or more chronic diseases. Those with lower incomes and less than a high school education were more likely to have a chronic disease and to report smoking tobacco products.
The authors concluded that marijuana use and smoking tobacco products, but not alcohol use were found to be significant in older adults with chronic disease. Preventative measures such as screening tools, education, and providing resources to patients should be targeted to populations at risk to promote overall health outcomes.
“As the substance use crisis continues to impact individuals across the state, it is more important than ever that we provide support to older adults who may be suffering from chronic conditions,” continued Dr. Ahuja. “This includes efforts to increase social support, outreach from community groups, hospitals and other organizations as it can be extremely challenging, stressful to be suffering from chronic disease for both the individual and their families."