Where You Live, Income May Play Significant Roles in
Falls by Senior Citizens
Elderly living in lower-income neighborhoods at
highest risk of injury on on sidewalks, streets and curbs
23, 2014 – A bit of good news for senior citizens about falling is that
you are twice as safe from tumbling to the ground when you are walking
for recreation or exercise that as you are when you a walking for some
necessity – like shopping, or going to an appointment. The not so good
news is that it is elderly with lower incomes who are most often walking
because they have to.
"Older adults have two times the risk of falling
while walking out of necessity than walking for recreation, and four
times greater risk of injury from a fall on a sidewalk than in a
recreational area," said Wenjun Li, PhD, associate professor of medicine
in the Division of Preventive and Behavioral Health at
UMass Medical School and lead author of the study.
Dr. Li and co-authors investigated the association
between the walking habits of older adults, the socioeconomic status of
their neighborhoods, and the occurrence of outdoor falls. They used data
from the Maintenance of Balance, Independent Living, Intellect and Zest
in the Elderly of Boston Study, which measured multiple attributes that
might impact an individual's risk of falling.
They found that older adults in poorer
neighborhoods do more walking for appointments or errands and experience
higher rates of fall on sidewalks, streets and curbs.
Falls on sidewalks and streets were more likely to
result in an injury than were falls in recreational areas despite the
fact that they walked far less than recreational-only and dual walkers.
"These differences were not explained by individual
factors such as an elder's health, leading us to conclude the
environment may play a significant role" noted Li. "Further research
will explore how elders interact with their environment and how to make
neighborhoods safer for utilitarian walking."
With falls the leading cause of fatal and nonfatal
injuries in adults aged 65 and older, fall prevention is one of the four
priorities of the Prevention and Wellness Trust Fund which was
established by the DPH in July 2012. Created to reduce health care costs
by preventing chronic conditions in communities across the Commonwealth,
the trust fund is the largest public health program in state history.
"This study will further inform our ongoing work to
prevent falls among older adults," said Madeleine Biondolillo, MD,
associate commissioner of the DPH and a co-author of the study.
Recognizing the impact that the built environment
has on falls, DPH has collaborated with the Massachusetts Association of
Councils on Aging to develop a Healthy Community Design program. It has
also funded seven Mass in Motion communities to actively work with
stakeholders on policy, systems and environmental approaches to healthy
"Improving the safety of walking environments in
areas where older adults shop and do other errands of necessity is an
important component of fall prevention," Li and the DPH concluded.
"Utilitarian Walking, Neighborhood Environment, and
Risk of Outdoor Falls" was published in the July 17 issue of the
American Journal of Public Health.
Co-authors at the study were from Massachusetts
Department of Public Health (DPH), Harvard Medical School and UMass