FALL INJURIES among older adults in MASSACHUSETTS Massachusetts

FALL INJURIES among older adults in MASSACHUSETTS Massachusetts Commission on Falls Prevention Meeting November 9, 2017 Laura Stadelmann Kersanske, MPH Preliminary data. Please contact DPH MA Commission on Falls Prevention staff before sharing or using this data: Injury and Violence Prevention Epidemiologist. Carla Cicerchia, 617 624 -5965 Massachusetts Department of Public Health

528 Deaths 1 52 / 100, 000 23, 772 Hospital Stays 2 2, 274 / 100, 000 Nu mb er of in jur ies de cre as es as inj u ry s ev e rity inc re as es BURDEN OF FALL INJURIES AMONG ADULTS 65+ Data are preliminary; please do not distri 51, 322 Emergency Department Visits 2 4, 910 / 100, 000 1 Deaths are for calendar year 2014. Source: Registry of Vital Records and Statistics, MA Department of Public Health. stays and emergency department visits are for fiscal year 2015. Source: MA Inpatient Hospital Discharge, Outpatient Observation Stay, and Emergency Department Discharge Databases, MA Center for Health Information and Analysis. 2 Hospital

BURDEN OF FALL INJURIES AMONG ADULTS 65+ Data are preliminary; please do not distri 528 Deaths 1 52 / 100, 000 23, 772 Hospital Stays 2 2, 274 / 100, 000 51, 322 Emergency Department Visits 2 4, 910 / 100, 000 1 Deaths are for calendar year 2014. Source: Registry of Vital Records and Statistics, MA Department of Public Health. stays and emergency department visits are for fiscal year 2015. Source: MA Inpatient Hospital Discharge, Outpatient Observation Stay, and Emergency Department Discharge Databases, MA Center for Health Information and Analysis. 2 Hospital

BURDEN OF FALL INJURIES AMONG ADULTS 65+ Data are preliminary; please do not distri 528 Deaths 1 52 / 100, 000 23, 772 Hospital Stays 2 2, 274 / 100, 000 51, 322 Emergency Department Visits 2 4, 910 / 100, 000 1 Deaths are for calendar year 2014. Source: Registry of Vital Records and Statistics, MA Department of Public Health. stays and emergency department visits are for fiscal year 2015. Source: MA Inpatient Hospital Discharge, Outpatient Observation Stay, and Emergency Department Discharge Databases, MA Center for Health Information and Analysis. 2 Hospital

BURDEN OF FALL INJURIES AMONG ADULTS 65+ Data are preliminary; please do not distri 528 Deaths 1 52 / 100, 000 23, 772 Hospital Stays 2 2, 274 / 100, 000 51, 322 Emergency Department Visits 2 4, 910 / 100, 000 1 Deaths are for calendar year 2014. Source: Registry of Vital Records and Statistics, MA Department of Public Health. stays and emergency department visits are for fiscal year 2015. Source: MA Inpatient Hospital Discharge, Outpatient Observation Stay, and Emergency Department Discharge Databases, MA Center for Health Information and Analysis. 2 Hospital

LEADING CAUSE OF INJURY AMONG ADULTS 65+ 1 Deaths Data are preliminary; please do not distri Falls are the leading cause of injury deaths 1 among older adults in MA. 53% Falls are the leading cause of injury hospitalizations 2 among older adults in MA. 67 % are for calendar year 2014. Source: Registry of Vital Records and Statistics, MA Department of Public Health. discharges are for fiscal year 2015. Source: MA Inpatient Hospital Discharge Database, MA Center for Health Information and Analysis. 2 Hospitalization

Data are preliminary; please do not distri RATE OF UNINTENTIONAL FALL-RELATED ED VISITS AMONG ADULTS 65+ Trends, FY 2011 – FY 2015 Rate per 100, 000 population 12, 000 85+ 10, 000 8, 000 6, 000 75 -84 4, 000 65 -74 2, 000 0 FY 2011 FY 2012 FY 2013 FY 2014 FY 2015 Fall-related ED visits increased slightly between FY 2011 and FY 2015 for all age groups, with the largest increase (9%) seen among adults ages 85+. Source: MA Emergency Department Discharge Database, MA Center for Health Information and Analysis.

Data are preliminary; please do not distri RATE OF UNINTENTIONAL FALL-RELATED ED VISITS AMONG ADULTS 65+ Trends, FY 2011 – FY 2015 Rate per 100, 000 population 12, 000 85+ 10, 000 8, 000 6, 000 75 -84 4, 000 65 -74 2, 000 0 FY 2011 FY 2012 FY 2013 FY 2014 Fall-related ED visits increase as age increases. Source: MA Emergency Department Discharge Database, MA Center for Health Information and Analysis. FY 2015

Data are preliminary; please do not distri RATE OF UNINTENTIONAL FALL-RELATED HOSPITAL STAYS AMONG ADULTS 65+ Trends, FY 2011 – FY 2015 Rate per 100, 000 population 8, 000 85+ 6, 000 4, 000 75 -84 2, 000 65 -74 0 FY 2011 FY 2012 FY 2013 FY 2014 FY 2015 Fall-related hospital stays remained fairly consistent between FY 2011 and FY 2015 for all age groups. Source: MA Inpatient Hospital Discharge and Outpatient Observation Stay Databases, MA Center for Health Information and Analysis.

Data are preliminary; please do not distri RATE OF UNINTENTIONAL FALL-RELATED HOSPITAL STAYS AMONG ADULTS 65+ Trends, FY 2011 – FY 2015 Rate per 100, 000 population 8, 000 85+ 6, 000 4, 000 75 -84 2, 000 65 -74 0 FY 2011 FY 2012 FY 2013 FY 2014 FY 2015 Fall-related hospital stays increase as age increases. Source: MA Inpatient Hospital Discharge and Outpatient Observation Stay Databases, MA Center for Health Information and Analysis.

Data are preliminary; please do not distri RATE OF UNINTENTIONAL FALL-RELATED DEATHS AMONG ADULTS 65+ Trends, 2010 - 2014 Rate per 100, 000 population 250 200 85+ 150 100 75 -84 50 65 -74 0 2011 2012 2013 2014 Fall-related deaths remained relatively stable between 2010 and 2014 for adults ages 65 -74. Over the same time period, death rates increased among those ages 75 -84 and 85+. Source: Registry of Vital Records and Statistics, MA Department of Public Health.

Data are preliminary; please do not distri RATE OF UNINTENTIONAL FALL-RELATED DEATHS AMONG ADULTS 65+ Trends, 2010 - 2014 Rate per 100, 000 population 250 200 85+ 150 100 75 -84 50 65 -74 0 2011 2012 2013 Fall-related deaths increase as age increases. Source: Registry of Vital Records and Statistics, MA Department of Public Health. 2014

Data are preliminary; please do not distri DISPARITIES IN NONFATAL FALL-RELATED INJURIES AMONG ADULTS 65+, FY 2015 By Sex, Age, and Race/Ethnicity 20, 000 17, 172 18, 000 Rate per 100, 000 population 16, 000 14, 000 12, 000 10, 000 8, 269 8, 221 7, 761 6, 496 6, 000 4, 644 5, 159 3, 969 4, 000 3, 372 2, 000 0 Male Female 65 -74 75 -84 85+ Black, NH Hispanic Asian/PI, White, NH NH Rates are age-adjusted, except for rates by age group. Source: MA Inpatient Hospital Discharge, Outpatient Observation Stay, and Emergency Department Discharge Databases, MA Center for Health Information

Data are preliminary; please do not distri DISPARITIES IN NONFATAL FALL-RELATED INJURIES AMONG ADULTS 65+, FY 2015 By Sex, Age, and Race/Ethnicity 20, 000 17, 172 18, 000 Rate per 100, 000 population 16, 000 14, 000 12, 000 10, 000 8, 269 8, 221 7, 761 6, 496 6, 000 4, 644 5, 159 3, 969 4, 000 3, 372 2, 000 0 Male Female 65 -74 75 -84 85+ Black, NH Hispanic Asian/PI, White, NH NH In FY 2015, the rate of nonfatal fall-related injuries among females was 1. 3 x higher than the rate among males. Rates are age-adjusted, except for rates by age group. Source: MA Inpatient Hospital Discharge, Outpatient Observation Stay, and Emergency Department Discharge Databases, MA Center for Health Information

Data are preliminary; please do not distri DISPARITIES IN NONFATAL FALL-RELATED INJURIES AMONG ADULTS 65+, FY 2015 By Sex, Age, and Race/Ethnicity 20, 000 17, 172 18, 000 Rate per 100, 000 population 16, 000 14, 000 12, 000 10, 000 8, 269 8, 221 7, 761 6, 496 6, 000 4, 644 5, 159 3, 969 4, 000 3, 372 2, 000 0 Male Female 65 -74 75 -84 85+ Black, NH Hispanic Asian/PI, White, NH NH The rate of nonfatal fall-related injuries among adults 85+ was 2 x higher than the rate among those 75 -84 and 4 x higher than the rate among those 65 -74. Rates are age-adjusted, except for rates by age group. Source: MA Inpatient Hospital Discharge, Outpatient Observation Stay, and Emergency Department Discharge Databases, MA Center for Health Information

Data are preliminary; please do not distri DISPARITIES IN NONFATAL FALL-RELATED INJURIES AMONG ADULTS 65+, FY 2015 By Sex, Age, and Race/Ethnicity 20, 000 17, 172 18, 000 Rate per 100, 000 population 16, 000 14, 000 12, 000 10, 000 8, 269 8, 221 7, 761 6, 496 6, 000 4, 644 5, 159 3, 969 4, 000 3, 372 2, 000 0 Male Female 65 -74 75 -84 85+ Black, NH Hispanic Asian/PI, White, NH NH White, non-Hispanic residents had the highest rate of nonfatal fall-related injuries while Asian/Pacific Islanders had the lowest rate. Rates are age-adjusted, except for rates by age group. Source: MA Inpatient Hospital Discharge, Outpatient Observation Stay, and Emergency Department Discharge Databases, MA Center for Health Information

DISPARITIES IN FATAL FALL-RELATED INJURIES AMONG ADULTS 65+, 2014 By Sex, Age, and Race/Ethnicity Data are preliminary; please do not distri 186. 0 200 180 Rate per 100, 000 population 160 140 120 100 80 70. 0 60. 5 46. 9 60 50. 8 57. 3 40 19. 2 18. 1 10. 3 20 0 Male Female 65 -74 75 -84 Rates are age-adjusted, except for rates by age group. Source: Registry of Vital Records and Statistics, MA Department of Public Health. 85+ Black, NH Hispanic Asian/PI, White, NH NH

DISPARITIES IN FATAL FALL-RELATED INJURIES AMONG ADULTS 65+, 2014 By Sex, Age, and Race/Ethnicity Data are preliminary; please do not distri 186. 0 200 180 Rate per 100, 000 population 160 140 120 100 80 70. 0 60. 5 46. 9 60 50. 8 57. 3 40 19. 2 18. 1 10. 3 20 0 Male Female 65 -74 75 -84 85+ Black, NH Hispanic Asian/PI, White, NH NH In 2014, the rate of fall-related deaths among males was 1. 5 x higher than the rate among females. Rates are age-adjusted, except for rates by age group. Source: Registry of Vital Records and Statistics, MA Department of Public Health.

DISPARITIES IN FATAL FALL-RELATED INJURIES AMONG ADULTS 65+, 2014 By Sex, Age, and Race/Ethnicity Data are preliminary; please do not distri 186. 0 200 180 Rate per 100, 000 population 160 140 120 100 80 70. 0 60. 5 46. 9 60 50. 8 57. 3 40 19. 2 18. 1 10. 3 20 0 Male Female 65 -74 75 -84 85+ Black, NH Hispanic Asian/PI, White, NH NH The rate of fall-related deaths among adults 85+ was 3 x higher than the rate among those 75 -84 and 18 x higher than the rate among those 65 -74. Rates are age-adjusted, except for rates by age group. Source: Registry of Vital Records and Statistics, MA Department of Public Health.

DISPARITIES IN FATAL FALL-RELATED INJURIES AMONG ADULTS 65+, 2014 By Sex, Age, and Race/Ethnicity Data are preliminary; please do not distri 186. 0 200 180 Rate per 100, 000 population 160 140 120 100 80 70. 0 60. 5 46. 9 60 50. 8 57. 3 40 19. 2 18. 1 10. 3 20 0 Male Female 65 -74 75 -84 85+ Black, NH Hispanic Asian/PI, White, NH NH White, non-Hispanic residents had the highest rate of fall-related deaths while Hispanic and Black, non-Hispanic residents had the lowest rate. Rates are age-adjusted, except for rates by age group. Source: Registry of Vital Records and Statistics, MA Department of Public Health.

FALLS AMONG OLDER ADULTS: IN SUMMARY 01 02 04 05 Leading cause of injury deaths and hospitalizations among adults ages 65+ in MA. 03

FALLS AMONG OLDER ADULTS: IN SUMMARY 01 02 04 05 Leading cause of injury deaths and hospitalizations among adults ages 65+ in MA. Slight increase in ED visits and deaths over last 5 years of available data. 03

FALLS AMONG OLDER ADULTS: IN SUMMARY 01 Leading cause of injury deaths and hospitalizations among adults ages 65+ in MA. 04 02 Slight increase in ED visits and deaths over last 5 years of available data. 05 03 ED visits, hospital stays, and deaths increase as age increases.

FALLS AMONG OLDER ADULTS: IN SUMMARY 01 Leading cause of injury deaths and hospitalizations among adults ages 65+ in MA. 04 Nonfatal and fatal injuries higher among older age groups and White residents. 02 Slight increase in ED visits and deaths over last 5 years of available data. 05 03 ED visits, hospital stays, and deaths increase as age increases.

FALLS AMONG OLDER ADULTS: IN SUMMARY 01 Leading cause of injury deaths and hospitalizations among adults ages 65+ in MA. 04 Nonfatal and fatal injuries higher among older age groups and White residents. 02 Slight increase in ED visits and deaths over last 5 years of available data. 05 Nonfatal injuries higher among females while fatal injuries higher among males. 03 ED visits, hospital stays, and deaths increase as age increases.

NEXT STEPS IN DATA ANALYSIS Length of hospital stay Discharges to skilled nursing facility Projected costs (costs to Medicare) Location/circumstances of fall ? Survey data (BRFSS)

laura. kersanske@state. ma. us