Background: Falls are considered a major global public health issue due to the associated number of fatalities. Additionally, older adults experience the highest mortality rate from falls globally. This study analyzed mortality trends and disparities among adults aged 65 and older from 1999 to 2020.
Methods: Analysis of fall-related deaths in the US from 1999-2020 was conducted using death certificate data from the CDC WONDER database, utilizing the ICD-10 code W00-19. Age-adjusted mortality rates (AAMR) per 100,000 population were extracted, and trends were analyzed using Joinpoint regression to calculate the Average Annual Percent Change (AAPC) with p value for statistical significance. Data were stratified using year, gender, race/ethnicity and geographical regions.
Results: Between 1999 and 2020, Fall accounted for 605,527 deaths among U.S. adults aged ≥65 years. Most deaths occurred in medical facilities (59.0%) followed by nursing homes (17.6%). The overall AAMR for Fall-related deaths increased from 40.46 in 1999 to 89.65 in 2020, with an AAPC of 3.96 (p< 0.01). Men showed higher AAMRs than women (77.73 vs. 57.22), with a more pronounced increase in women (AAPC: 4.12, p< 0.01), compared to men (AAPC: 3.54, p< 0.01). Racial disparities were significant, with NH Whites having the highest AAMR (71.15), followed by NH American Indian (61.40), Hispanic (42.73), NH Asians or Pacific Islanders (40.38), and NH Black (29.13). The incline in AAMR throughout the study was most pronounced in Whites (AAPC: 4.29, p< 0.01). Geographically, the highest AAMRs were observed in Wisconsin (147.16) and the lowest in Alabama (28.78). Midwestern U.S. had the highest regional AAMR (76.2), followed by the West (71.88), South (61.30), and Northeast (53.25). Metropolitan areas had higher AAMRs than nonmetropolitan areas (65.48 vs. 64.52), though nonmetropolitan areas showed more steeper incline from 1999 to 2020 (Nonmetropolitan: AAPC: 4.00, p< 0.01).
Conclusions: This study reveals significant demographic disparities in mortality rates related to falls among older adults. These findings highlight the need for targeted interventions, improved fall prevention strategies, and enhanced access to healthcare to reduce mortality and improve outcomes in this vulnerable population.
