North Carolina Leadership

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Kathleen Andrews
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North Carolina Leadership Making a Difference to Address Falls Prevention Did you Know every year in the United States, more than 1/3 of adults age 65+ have a fall, with approximately 1/5 of fallers

North Carolina Falls Facts As our population ages, fall injuries in North Carolina are an increasingly serious public health issue.

1 North Carolina Leadership Making a Difference to Address Falls Prevention Did you Know every year in the United States, more than 1/3 of adults age 65+ have a fall, with approximately 1/5 of fallers sustaining a serious injury? Research indicates that people who fall are 2-3 times more likely to fall again, and each fall increases the likelihood of more serious injury or death. North Carolina Falls Facts As our population ages, fall injuries in North Carolina are an increasingly serious public health issue. Falls are the fourth leading cause of unintentional injury death for North Carolinians of all ages. Unintentional fall deaths increased by more than 150% from 1999 to The NC unintentional fall death rate has been steadily increasing since 2006 and has increased by 80% since In 2000, 345 NC residents of all ages died due to unintentional falls (rate of 35.5 per 100,0000). In 2013, the number of deaths due to unintentional falls (all ages) increased to 820 (rate of 58.3 per 100,000). The increases in unintentional fall death rates among the general population have been driven by increases in rates among those ages 65 and older. Eighty-five percent of unintentional fall deaths in NC are among 65 and older; 47% among 85 and older. There has been a smaller increase among those less than 65 years of age (93 deaths or a rate of 1.3 per 100,000 in 2000, 140 deaths or 1.6 per 100,000 in 2013). NC Unintentional Falls Death in NC by Age (2013): o Higher absolute number among males than females up until age 75 o Higher absolute number among females than males for 85+ o Female 85+: per 100,000; 288 deaths o Male 85+: per 100,000; 163 deaths o Higher rate per 100,000 for males compared to females across all ages o Female 75-84: 52.5 per 100,000 o Male 85+: 72.4 per 100,000

Overall, the NC hospitalization rate for unintentional falls has decreased slightly since 2004.

Outcomes of unintentional falls hospitalizations among ages 65+ who have the highest rates of unintentional fall hospitalizations (71% of all unintentional fall hospitalizations) and experience more

2 Overall, the NC hospitalization rate for unintentional falls has decreased slightly since The rate of unintentional falls related emergency department visits increased , then decreased through Outcomes of unintentional falls hospitalizations among ages 65+ who have the highest rates of unintentional fall hospitalizations (71% of all unintentional fall hospitalizations) and experience more severe consequences (2012): Over half (54%) were discharged to a skilled nursing facility 13% required home health services, 7% were sent to rehab, 3% died For those <65 years, 60% are discharged home, 17% require home health services, 12% are discharged to a skilled nursing facility The leading cause of traumatic brain injury (TBI)-related hospitalizations among North Carolina residents in 2012 was unintentional falls, with a rate of 24.8 hospitalizations per 100,000 residents. Across all age groups, males were more likely than females to be hospitalized for an unintentional fall-related TBI. Unintentional fall related hospitalizations were more common among the youngest and the oldest age groups for both males and females. The highest rate of unintentional fall-related TBI hospitalizations was among adults aged 75 years and older; the second-highest rate was among children less than 1 year old. In 2012, 27% of North Carolina adults ages 45 and over reported one or more falls in last three months. Of those who reported a fall in the last three months, 28% of males and 41% of females reported that the fall caused an injury that resulted in a limitation of regular activities for at least a day or the need to go see a doctor. Fall Deaths are Only the Tip of the Iceberg Deaths Hospitalizations Emergency Dept. Visits Medically Unattended Fall injuries that cause death in North Carolina are only the tip of the injury iceberg The largest numbers of people with fall injuries are those who do not go to see a doctor, receive no medical care, or treat themselves. As the population ages, the impact and cost of fall-related deaths and injuries will increase dramatically unless funding is increased to address the issue.

3 North Carolina Responds Falling is NOT an inevitable result of aging. Through evidence-based interventions, practical lifestyle adjustments, and capacity-building to address falls prevention through community partnerships, we can substantially reduce the number of falls. North Carolina is taking action to prevent falls through the following initiatives: Establish and maintain a statewide Falls Prevention Coalition of key state, regional, and community stakeholders to systematically identify needs, resources and successes and to build capacity for falls prevention throughout the state. Develop and apply effective social marketing materials and practices to engage and better inform the public and constituencies about falls risks and proven strategies to reduce falls. Identify, develop and implement training programs at state, regional, and community levels for both clinical and community providers to raise falls prevention awareness and enable them to plan, deliver and evaluate effective evidence-based falls prevention programs and practices/interventions. Create and implement plans to identify and establish necessary complements of risk assessment and intervention strategies at the state, regional and community levels to address the varying and diverse needs of those at risk for falls. Monitor the growth and outcomes of falls prevention initiatives. Evaluate and disseminate findings and lessons learned from the process and outcomes of the initiative on at least an annual basis. Use information and conclusions to set new goals and strategies for upcoming year and seek resources to continue falls prevention activities. Assess, advocate, and facilitate the development of policies, environments, and resources that advance falls prevention. Establish a centralized hub that will: o Offer a single point of entry for participants, providers, and implementers to receive and disseminate falls and falls-risk activities and programs; o Create a continuum of care toolkit and business plan for sustainability; and o Conduct data entry, program evaluations and quality assurance. Promote Evidence-Based Falls Programs such as: o Building Better Balance, a falls risk screening process for community-dwelling older adults. o A Matter of Balance, an eight session community-based workshop designed to reduce the fear of falling and increase activity levels. o Otago, an individually tailored program of muscle strengthening and balance-retraining exercises, combined with a walking program, for frail older adults living at home. o Tai Ji Quan: Moving for Better Balance, a research-based balance training regimen designed for older adults and people with balance disorders.

4 Contact Information Nidhi Sachdeva Injury Prevention Consultant NC Division of Public Health Chronic Disease and Injury Section, Injury and Violence Prevention Branch 5505 Six Forks Road Raleigh, NC Ellen Schneider UNC Center for Health Promotion and Disease Prevention NCOA National Falls Prevention Resource Center 1700 MLK Jr. Blvd., CB 7426 Chapel Hill, NC (919) Source: State Center for Health Statistics, Vital Statistics-Deaths, 2012; N.C. State Center for Health Statistics, Vital Statistics-Hospitalizations, 2012; NC DETECT, 2012

5 Developed by the National Council on Aging (NCOA), a respected national leader and trusted partner to help people aged 60+ meet the challenges of aging. Our mission is to improve the lives of millions of older adults, especially those who are struggling. Learn more at ncoa.org

NC Division of Aging and Adult Services NC Center for Health & Wellness, UNC Asheville (828)

2017 National Falls Prevention Awareness Day 10 Years Standing Together to Prevent Falls September 22, 2017 Dear Falls Prevention Partners: The NC Division of Aging and Adult Services is excited to partner