Objective To examine sociodemographic factors associated with having unmet needs in medications, mental health, and food security among older adults during the COVID‐19 pandemic. Data Sources and Study Setting Primary data and secondary data from the electronic health records (EHR) in an age‐friendly academic health system in 2020 were used. Study Design Observational study examining factors associated with having unmet needs in medications, food, and mental health. Data Collecting/Extraction Methods Data from a computer‐assisted telephone interview and EHR on community‐dwelling older patients were analyzed. Principle Findings Among 3400 eligible patients, 1921 (53.3%) (average age 76, SD 11) responded, with 857 (45%) of respondents having at least one unmet need. Unmet needs for medications were present in 595 (31.0%), for food in 196 (10.2%), and for mental health services in 292 (15.2%). Racial minorities had significantly higher probabilities of having unmet needs for medicine and food, and of being referred for services related to medications, food, and mental health. Patients living in more resource‐limited neighborhoods had a higher probability of being referred for mental health services. Conclusions Age‐friendly health systems (AFHS) and their recognition should include assessing and addressing social risk factors among older adults. Proactive efforts to address unmet needs should be integral to AFHS.

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