MHLU - Health Status Resource

Falls

Falls

Key Findings: 

The rates of injuries due to falls have been increasing in Middlesex-London since 2016 after showing a decreasing trend in the years before. Females and those in rural populations are more likely to experience a fall-injury than their counterparts. While falls affect all ages across the lifespan, the youngest and oldest in our population bear the highest burden.

About 20% of the Middlesex-London population reported a fall in the year prior to the survey in the combined years of 2012-13(Figure 4.3.1).

Of those who reported a fall in the 2012-13 survey, 34.2% indicated that it affected their daily activities. Generally, the younger age groups reported lower rates of having an impact on daily activities, but the difference was not significant. No differences were seen by socioeconomic factors such as income or education level (not shown).

In 2012, the age-standardized rate of deaths due to falls in Middlesex-London was 15.4 per 100,000 and did not change significantly between 2005 and 2012 (Figure 4.3.2).

While the rate of deaths due to falls in Middlesex-London remained lower than the Peer Group and provincial rates over the time period, this difference was not statistically significant (Figure 4.3.2).

Death rates due to falls increased as age increased, increasing dramatically after age 75 (214.8 per 100,000) (Figure 4.3.3). There were no differences seen between sexes or by urban/rural status (not shown).

The age-standardized rate of emergency department visits due to falls in Middlesex-London, however, increased significantly between 2015 (3,228.8 per 100,000) and 2017 (3,536.9). All gains realized from a reduction in falls-related emergency department visits between 2010 and 2015 have since been lost (Figure 4.3.4).

The rate of ED visits due to falls in Middlesex-London was significantly higher than both the Peer Group and the provincial rate in recent years (Figure 4.3.4).

ED visits related to falls were higher in females than males and the rural population compared to the urban population (not shown). 

The age-specific rates of ED visits due to falls were lowest in the age group 20-44. The rates increased dramatically after age 75. The age group with the next highest rate of fall-related ED visits was the under 5-year-old population (Figure 4.3.5).

Males between 0-4 were significantly more likely to visit the ED for a fall compared to females (Figure 4.3.6).

Falls on stairs represent about 10% of all ED visits in the 0-4 age group. No differences were seen between boys and girls (Figure 4.3.6).

Interpretation

Falls represented the highest total cost of all injury types; $2.8 billion in Ontario in 2010.Middlesex-London data shows no significant differences by sex for death due to falls but that females are more likely to visit the emergency department.

Similar to results seen in the Middlesex-London RRFSS survey, falls were the leading cause of all injuries, both fatal and non-fatal as reported in a large random digit dialing survey in the United States. Women were more likely to report a fall than men. 3

Falls on stairs occur in the oldest and very youngest in the population. In 2015 in Ontario, over 20% of the reported injuries sustained on stairs occurred to the head.4 Prevention of falls on stairs could have a substantial impact in reduction of concussions and other head injuries. The use of secured and properly installed gates, and carpeting on the stairs have been associated with reduced injury risk. 5

Ontario Public Health Standard: 

Ontario Public Health Standards: Requirements for Programs, Services, and Accountability – Substance Use and Injury Prevention (page 55)

Population Health Assessment and Surveillance Protocol, 2018

References:

1. Parachute. The cost of injury in Canada [Internet]. Version 2.2. Toronto (ON): Parachute; 2015 [2019 Feb 10]. 177 p.   Available from: http://www.parachutecanada.org/downloads/research/Cost_of_Injury-2015.pdf

2. Bergen G, Stevens MR, Burns ER. Falls and fall injuries among adults aged ≥65 years — United States, 2014. MMWR Morb Mortal Wkly Rep [Internet]. 2016 Sep [cited 2019 Feb 10];65(37):993-8. Available from: https://www.cdc.gov/mmwr/volumes/65/wr/mm6537a2.htm

3. Cowle S. Injuries from falls on stairs in Ontario [Internet]. Toronto (ON): Parachute; 2016 Dec [cited 2019 Feb 3]. 2 p.  (Ontario injury compass; no. 14). Available from: http://www.oninjuryresources.ca/downloads/compass/compass-2016-12-falls-...

4. Kendrick D, Zou K, Ablewhite J, Matson M, Coupland C, Kay B, Hawkins A, Reading R. Risk and protective factors for falls on stairs in young children: multicentre case–control study. Arch Dis Child [Internet]. 2016 Oct [cited 2019 Feb 10];101(10):909-16. Available from: https://adc.bmj.com/content/101/10/909.citation-tools

Last modified on: March 15, 2019