Falls represent a deadly public health problem, UN warns

The elderly exercise in Tai Chi, Thailand

1 September 2010 – Falls are a major public health problem across the world with an estimated 424,000 fatalities occurring each year, making it the second leading cause of unintentional injury and death after road traffic accidents, according to the United Nations health agency.

More than 80 per cent of fall-related fatalities occur in low-and middle-income countries, with regions of the Western Pacific and South East Asia accounting for more than two thirds of these deaths, the World Health Organization (WHO) said in a fact sheet issued today.

About 37.3 million falls severe enough to require medical attention occur each year. The largest morbidity occurs in people aged 65 years or older, young adults aged between 15 and 29 years and children aged 15 years or younger.

People who fall and suffer a disability, particularly older people, are at a major risk for subsequent long-term care and institutionalization, according to WHO. For people aged 65 years or older, the average cost to the health system per fall injury in Finland and Australia are $3,611 and $1,049 respectively.

Evidence from Canada has linked the implementation of effective fall prevention strategies with a subsequent 20 per cent reduction in the incidence of falls among children under the age of 10 and net savings of more than $120 million each year.

While all people who fall are at risk of injury, the age, gender and health of the individual can affect the type and severity of injury.

Older people have the highest risk of death or serious injury arising from a fall and the risk increases with age. For example, in the United States, 20 per cent to 30 per cent of older people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head traumas. This risk level may be in part due to physical, sensory, and cognitive changes associated with ageing, in combination with environments that are not adapted for an aging population.

Across all age groups and regions, both genders are at risk of falls. In some countries, it has been noted that males are more likely to die from a fall, while females suffer more non-fatal falls.

According to WHO, fall prevention strategies should be comprehensive and multifaceted. They should prioritize research and public health initiatives to further define the burden, explore variable risk factors and utilize effective prevention strategies.

They should also support policies that create safer environments and reduce risk factors and should promote engineering to remove the potential for falls, the training of health-care providers on evidence-based prevention strategies; and the education of individuals and communities to build risk awareness.


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