Visit Rates for Adolescents and Adults With Mental Health Disorders, Substance Use Disorders, or Both Disorders at Health Centers, by Age: United States, 2022

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by Loredana Santo, M.D., M.P.H., Lello Guluma, M.P.H., and Jill J. Ashman, Ph.D.

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In 2022, 84.2 million adults and 6.1 million adolescents were diagnosed with a mental health disorder (MHD) or substance use disorder (SUD) (1). Health centers are community-based clinics that offer primary care to underserved communities. In 2022, health centers offered MHD services to 2.7 million patients and SUD services to about 299,000 patients (2). This report presents rates for MHDs, SUDs, and both MHDs and SUDs by age group for visits to health centers by people age 12 and older, based on the 2022 National Ambulatory Medical Care Survey Health Center Component.

In 2022, the health center visit rate for people age 12 and older with an MHD only was 50.5 visits per 1,000 people. This was higher than rates for people with an SUD only (10.3 visits) and both an MHD and SUD (12.8) Figure. Similar patterns were observed across all age groups, with rates for MHD only higher than rates for SUD only and both MHD and SUD. Rates for adolescents ages 12–17 with an SUD only (0.6) and with both an MHD and SUD (1.1) were the lowest. Rates for adults ages 26–49 (13.3) and 50 and older (11.9) with an SUD only were higher than rates for young adults ages 18–25 (3.2). Similarly, rates for adults ages 26–49 (19.0) and 50 and older (12.0) with both an MHD and SUD were higher than rates for young adults ages 18–25 (6.2). Rates for MHD only were not significantly different across age groups.

Data source and methods

The 2022 National Ambulatory Medical Care Survey Health Center Component includes visit data from electronic health records from federally qualified health centers and federally qualified health center look-alikes (health centers that meet federally qualified health center eligibility requirements but do not receive program funding) (3). Sampled health centers submitted data for more than 5.6 million visits (unweighted). Sampling design details for the National Ambulatory Medical Care Survey Health Center Component are described elsewhere (4). Weighting, which accounts for sampling probabilities and nonresponse, was conducted to produce national visit-level estimates of health centers from all 50 U.S. states and the District of Columbia (5). Visit weights were normalized to account for excluded health centers due to complete absence (missingness) of diagnosis variables (5).

Visit rates were calculated by dividing the number of health center visits by population estimates from the U.S. Census Bureau (6). Data analyses were performed using SAS-callable SUDAAN software (7). Reliability of estimates was assessed using National Center for Health Statistics data presentation standards for rates and counts (8). Differences in the distribution were based on chi-square tests (p < 0.05). This report uses the restricted-use file (5), and the population includes all visits by people age 12 and older, with age categories defined based on previous reports (1,9). Visits with any of the following codes in any of the diagnosis fields from the International Classification of Diseases, 10th Revision, Clinical Modification (10) were used to define MHD only: F01–F09 or F20–F99; and SUD only: F10–F19. MHD only and SUD only are mutually exclusive categories.

References

  1. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2022 National Survey on Drug Use and Health. 2023.
  2. U.S. Department of Health and Human Services, Health Resources and Services Administration. Health Center Program. 2022 uniform data system trends data brief. 2023.
  3. U.S. Department of Health and Human Services, Health Resources and Services Administration. What is a health center?
  4. Williams SN, Ukaigwe J, Ward BW, Okeyode T, Shimizu IM. Sampling procedures for the collection of electronic health record data from federally qualified health centers, 2021–2022 National Ambulatory Medical Care Survey. National Center for Health Statistics. Vital Health Stat Series 2(203). 2023. DOI: https://dx.doi.org/10.15620/cdc:127730.
  5. National Center for Health Statistics. Research Data Center National Ambulatory Medical Care Survey Health Center Component 2022 restricted use file data dictionary. 2023.
  6. U.S. Census Bureau. Postcensal estimates of the civilian noninstitutionalized population of the United States (estimates are from special tabulations developed for the National Center for Health Statistics by the Population Division, U.S. Census Bureau using the July 1, 2022, set of state population estimates).
  7. RTI International. SUDAAN (Release 11.0.3) [computer software]. 2018.
  8. Parker JD, Talih M, Irimata KE, Zhang G, Branum AM, Davis D, et al. National Center for Health Statistics data presentation standards for rates and counts. National Center for Health Statistics. Vital Health Stat 2(200). 2023. DOI: https://dx.doi.org/10.15620/cdc:124368.
  9. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health. 2022.
  10. Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services. International classification of diseases, 10th revision, clinical modification (ICD–10–CM). 2017.

Suggested citation

Santo L, Guluma L, Ashman JJ. Visit rates for adolescents and adults with mental health disorders, substance use disorders, or both disorders at health centers, by age: United States, 2022. NCHS Health E-Stats. 2024. DOI: https://dx.doi.org/10.15620/cdc/160501.

Figure

Figure. Visit rate for adolescents and adults with mental health disorders, substance use disorders, or both disorders at health centers, by age group: United States 2022

Figure is a bar chart showing health center visit rates for adolescents and adults with mental health disorders, substance use disorders, and both disorders in the United States in 2022 overall and by age group. Categories shown are total, 12–17, 18 25, 26–49, and 50 and older.
1Rate significantly higher than rates for substance use disorder only and both mental health and substance use disorders, overall and among all age groups.
2Rate significantly higher than rate for adolescents ages 12–17.
3Rate significantly higher than rates for adolescents ages 12–17 and adults ages 18–25.
NOTES: Rates are based on a sample of 95.8 million visits by adolescents and adults age 12 and older. Mental health disorders are defined as visits with an International Classification of Diseases, 10th Revision, Clinical Modification (ICD–10–CM) code between F01 and F09 or F20 and F99. Substance use disorders are defined as visits with an ICD–10–CM code between F10 and F19. Mental health disorder only and substance use disorder only are mutually exclusive categories.
SOURCE: National Center for Health Statistics, National Ambulatory Medical Care Survey Health Center Component, 2022.

Table

Table. Visit rate for adolescents and adults with mental health disorders, substance use disorders, or both disorders at health centers, by age group: United States, 2022

Table 1. Number of live births, maternal deaths, and maternal mortality rates, by race and Hispanic origin and age: United States, 2018-2020
Disorder and age group Rate per 1,000 people 95% confidence interval
Total:
Mental health disorder only 50.5 36.0–64.9
Substance use disorder only 10.3 7.1–13.6
Both disorders 12.8 6.5–19.2
12–17:
Mental health disorder only 63.2 41.1–85.4
Substance use disorder only 0.6 0.3–0.9
Both disorders 1.1 0.5–1.6
18–25:
Mental health disorder only 51.9 35.9–68.0
Substance use disorder only 3.2 2.0–4.5
Both disorders 6.2 3.0–9.4
26–49:
Mental health disorder only 54.5 39.2–69.8
Substance use disorder only 13.3 8.7–17.9
Both disorders 19.0 8.6–29.5
50 and older:
Mental health disorder only 43.8 30.5–57.0
Substance use disorder only 11.9 8.0–15.8
Both disorders 12.0 6.1–17.9

NOTES: Rates are based on a sample of 95.8 million visits by adolescents and adults age 12 and older. Visit rates are based on the July 1, 2022, set of estimates of the U.S. civilian noninstitutionalized population, as developed by the U.S. Census Bureau Population Division. Mental health disorders are defined as visits with an International Classification of Diseases, 10th Revision, Clinical Modification (ICD–10–CM) code between F01 and F09 or F20 and F99. Substance use disorders are defined as visits with an ICD–10–CM code between F10 and F19. Health centers where all the diagnoses were missing for any visits were excluded, and visit weights for the remaining health centers were normalized to account for the health centers that were excluded. Mental health disorder only and substance use disorder only are mutually exclusive categories.
SOURCE: National Center for Health Statistics, National Ambulatory Medical Care Survey Health Center Component, 2022.