Using The Household Pulse Survey, the US Census Bureau recently released data showing that, while older adults experienced fewer mental health challenges than younger adults during the COVID-19 pandemic, anxiety and depression levels among those 65 and older varied depending on their demographic characteristics and economic well-being.

The Household Pulse Survey (HPS) was designed to deploy quickly and efficiently, collecting data to measure how emergent issues are impacting U.S. households from a social and economic perspective. Data is meant to be disseminated in near real-time to inform federal and state action.

The Household Pulse Survey has provided regular insight into respondents’ mental health and well-being throughout the pandemic.

Since April 2020, the HPS has asked two questions about anxiety symptoms and two questions about depression symptoms. This analysis relies on pooled data from two distinct collection phases of the survey:

• Phase 1 (April 23-July 21, 2020) – 14.2 million invitations, 1.1 million responses, 7.7% response rate.
• Phase 3.10 (August 23-October 30, 2023) – 3.2 million invitations sent, 220,664 responses, 7.0% response rate.

These two collection phases enabled Census researchers to analyze data over roughly a three-year period, providing a snapshot of experiences during the pandemic’s early days and after the pandemic emergency ended.

The degree to which adults 65 and older struggled with mental health varied by sociodemographic factors.

During Phase 1, older women (26.5%) were more likely than older men (18.6%) to struggle with mental health. This disparity was also present during Phase 3.10, with more older women (21.5%) than men (16.9%) reporting symptoms in the latest cycle.

Reported struggles with anxiety and depression, however, decreased among both groups during the cycle, indicating mental health outcomes broadly improved as the pandemic progressed.

Other characteristics associated with older adults’ mental health:

• Education.  The percentage of the older population struggling with mental health decreased when educational attainment was higher: Nearly a third (32.6%) of those with less than a high school diploma experienced mental health struggles compared to 12.9% of those with a bachelor’s degree or higher.
• Health insurance. The vast majority of older adults receive health insurance through Medicare. Those who were not insured (40.7%) were more likely to experience mental health struggles than those who had health insurance (19.1%). Roughly 3 in 10 older adults insured via Medicaid struggled with mental health, a number that was not statistically different from those without any insurance.
• Disability. Older adults with a disability (44.9%) were much more likely than those without one (13.6%) to struggle with mental health, a finding that reflects the relationship between physical and mental health outcomes for the population in general and for older adults in particular.
• Economic Security. Older adults who reported food insufficiency were also more likely to report symptoms of mental health struggle (34.2%) than those who had enough food (11.2%). Similarly, those who struggled with paying basic household expenses were more likely to experience mental health challenges (28.2%) than those who did not struggle (7.8%).