Synergy: Chronic Disease Control & Senior Falls Prevention

Transcription

1 Synergy: Chronic Disease Control & Senior Falls Prevention Barb Alberson, M.P.H. Chief, State and Local Injury Control Section California Department of Public Health 1

2 Most MD Visits: Treating Chronic Diseases Women arthritis diabetes hypertension orthopedic problems (bunions) vision osteoporosis Men (if they go at all!) respiratory ailments (e.g., emphysema hearing 2

3 Chronic Diseases = More Vulnerable to (Fall) Injury Hypertension - dizzy when get up too fast Osteoporosis - brittle bones Diabetes - poor circulation in feet Arthritis - difficult to grip or maneuver Risk of fall Risk of fall then break/break then fall Risk of fall; scald in bathtub Risk of fall, burn, even car crash if can t turn head or grip wheel 3

4 Why Seniors Fall? Poor balance De-conditioned/ Out-of-Shape Health changes Medications/alcohol Hazardous environment Doing things they shouldn t do 4

5 Health Changes Falls are early warning system that chronic conditions are not being managed well I m the Canary in the mine! 5

6 Prevention? 6

7 Falls Prevention Strategies Address Chronic Conditions, too Physical Activity Esp. balance and mobility Environmental Issue Home Assessment Modification & Repair Outside Environment Medical Management Medication Review Treatment of Co-morbidities Vision Screening 7

8 No More Falls! Projects Collaboration among 3 programs in DHS (PHCA, SLIC, and C4PA) 2-year pilot in Fresno and Tulare 4-year CDC study in Humboldt and San Diego North PHNs conducted fall risk assessment as part of health assessment, provided education and resources; helped client create individualized action plan; did follow up Referred for community interventions 8

9 No More Falls! Primary Community Intervention Active Aging Task Forces 9

10 Silver Bullet Shotgun! National Institute on Aging states that exercise is the best thing seniors can do to stay healthy 10

11 Aging Issues: Physical Activity Can Reduce Risk Factors for Falls decreased coordination: gait and balance play a role PA here! poor circulation decreased muscle strength bone loss organs lose efficiency (kidneys) obesity depression here! And here! PA works here, too! And also here! here! here! 11

12 So to prevent falls AND promote wellness, we want more people more active more often! Yet only 1 in 4 seniors gets enough physical activity 12

13 Roller Blades Senior Center Tai Chi Need Menu of Options Different levels of risk No typical senior so no single strategy will appeal to all Cost, availability & accessibility Culture and language issues 13

14 cheap Walking is Preferred Males Females Walking 47-50% 40-50% Gardening 38-43% 22-28% Stretching 15-16% 18-22% Percentage of adults reporting participating in selected PA activities in prior two weeks. CDC, Nat. Center for Health Statistics 14

15 Can t just tell folks to go out and walk if it isn t safe, interesting or easily accessible......need conducive environment 15

16 Older Adults Cite Problems Walking Too hard (32%) Everything too far (25%) No place to rest (20%) Poor sidewalks (20%) Dangerous intersections (20%) Time it takes (16%) Crime (15%) Persons Age 75+, 10% or more reporting as a large problem; Source: Stowell Ritter A, Straight A, Evans E. Understanding Senior Transportation: Report and Analysis of Consumers Age 50+. Washington DC: AARP Public Policy Institute,

17 The Big Picture Policy and programs to encourage Walkable Communities 17

18 18

19 Robert Wood Johnson Foundation grant 3 community-based projects that focused on environmental and policy strategies Coalitions Walkability Audits and Senior Surveys Community/Advocacy Workshops Walk Clubs Walkability Maps and Educational Materials Presentations to Civic Policymakers Revisions to General Plans to be Elder-friendly 19

20 Morphing into 20

21 SAMTRAN s Senior Mobility Plan San Mateo, CA 21

22 San Mateo realizes silver tsunami is coming! Population 90,000 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,

23 ...and that ability to get around remains critical to well being 4 Travel Patterns Change with Age for All Purposes (Trips per person per day) Other Medical Religious or School Social or Recreation Personal Business Shopping Work 23

24 SAMTRANS Senior Mobility Solutions Improved public transportation Alternative community transit services Mobility management Community design for walking and transit Driving safety and driving wellness Improved licensing procedures Safer street and highway design Resources for family members 24

25 In summary?, 25

26 Chronic Disease Prevention + Falls Prevention provide entre into mainstream health promotion issues, They are complementary efforts! 26

27 d The end 27

28 Barb Alberson 28