This year’s National Public Health Week campaign will take place April 4-11. Throughout the week, the public’s attention will be directed towards messages about safety and injuries, including falls. According to national injury statistics, unintentional falls is one of the leading causes of injury among all age groups, particularly older adults. In fact, in 2009, there were more than 2.6 million emergency department visits among adults 60 years of age or older due to fall-related injuries. Like most injuries, falls are preventable, and knowing which population subgroups are disproportionately affected by falls can lead to more tailored prevention programs and messages.

The following article presents findings from PHMC’s 2010 Household Health Survey about falls within the past year among adults 60 years of age or older residing in the five-county Southeastern Pennsylvania (SEPA) region, which includes Bucks, Chester, Delaware, Montgomery, and Philadelphia Counties.

In SEPA, nearly one in five older adults (18.7%) has fallen within the past year, representing approximately 147,000 older adults in this region. Recent falls among older adults are examined by demographic, socio-economic, housing, geographic location, and health characteristics.

Demographic and socio-economic characteristics

When examining demographic and socio-economic characteristics among older adults residing in SEPA who have fallen with the past year, some disparities emerge.

• Adults 75 years of age and older (22.9%) are more likely than adults 60-74 years of age (16.5%) to have fallen within the past year (Figure 1).

• Older adult men (17.9%) and older adult women (19.3%) are similarly as likely to have fallen in the past year.

• One-quarter of older adults living below 150% of poverty (25.4%) have fallen within the past year, compared with 17.1% of older adults living at or above 150% of poverty (17.1%).

• More than one in five Latino older adults (22.2%) has fallen within the past year, compared with 19.0% of white older adults and 16.5% of black older adults.

Housing and geographic location characteristics Differences in recent falls among older adults living in SEPA have also been identified in terms of housing characteristics.

• Older adults who rent their home (25.4%) are more likely than older adults who own their home (17.5%) to have fallen in the past year (Figure 2).

• Older adults who live alone are slightly more likely (21.4%) than older adults who live with two or more individuals (17.9%) to have fallen within the past year.

• In the SEPA counties, 20.6% of older adults living in Chester County have fallen within the past year, compared with Philadelphia (20.2%), Bucks (19.6%), Montgomery (17.4%), and Delaware (14.4%) Counties.

Health characteristics

In addition to demographic, socio-economic, and housing characteristics, there are also differences in recent falls among older adults with some health or quality of life conditions.

• Older adults in fair or poor health (31.4%) are twice as likely as older adults in excellent, very good, or good health (15.0%) to have fallen within the past year.

• Older adults who have signs of major depression (32.7%) are twice as likely as older adults who do not have signs of major depression (16.4%) to have fallen within the past year.

• Older adults with one or more activities of daily living (ADL) limitation (46.9%), such as getting in and out of bed or getting dressed, are more likely than older adults without an ADL limitation (15.9%) to have fallen with the past year.

• Older adults with one or more instrumental activities of daily living (IADL) limitation (37.0%), such as preparing meals or shopping for groceries, are more likely than older adults without an IADL limitation (13.8%) to have fallen in the past year.

• Older adults who have a physical, mental, or emotional disability or condition lasting more than six months (36.8%) are more than twice as likely as older adults without a disability or condition (15.5%) to have fallen in the past year.

Falls can be a devastating event among older adults, as falls may lead to serious injuries such as bone fractures, lacerations, and other quality of life concerns. Fortunately, there are some preventive measures that can be taken to prevent falls among older adults. According to the Centers for Disease Control and Prevention (CDC), such measures include increasing leg strength and improving balance; having prescription medications reviewed by a healthcare professional to assess side effects and drug interactions; having an annual vision exam; increasing home safety practices such as improved lighting, installing grab bars, and removing tripping hazards such as loose carpeting; and wearing appropriate footwear with deep treads. Therefore, knowing which older adult population subgroups are more likely to have recently fallen can help inform the implementation of prevention programs and messages targeting older adults.

For more information about the Community Health Data Base, the Southeastern Pennsylvania Household Health Survey, or falls among older adults in the Southeastern Pennsylvania region, please contact Nicole Dreisbach at nicoled@phmc.org.

Note: Signs of major depression is created from the 10-item CES-D depression scale for older adults. Adults with four or more signs of depression are identified as having signs of major depression.

For more information about national non-fatal falls statistics about older adults, please visit: http://www.cdc.gov/injury/wisqars/nonfatal.html.

For more information from the Centers for Disease Control and Prevention (CDC) about falls among older adults, please visit: http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html.