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The Economic Costs of Injuries Among Older Adults
Injury and violence are a serious threat to the health and well-being of Americans ages 65 and older. Older adults are at higher risk for many types of injuries that can lead to death, disability, dependence, lost mobility, isolation and pain. In 2000, the injuries incurred by adults age 65 and older will also have financial consequences including total lifetime economic costs of more than $31 billion in medical expenses and lost productivity (Finkelstein 2006).
The Problem
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Falls are the leading cause of injury death (Murphy 2000) for Americans 65 years and older and the most common cause of nonfatal injuries and hospital admissions for trauma (Alexander 1992). More than a third of adults aged 65 years or older fall each year (Hornbrook 1994; Hausdorff 2001).
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Of those who fall, 20% to 30% suffer moderate to severe injuries that reduce mobility and independence, and increase the risk of premature death (Sterling 2001).
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In 2003, 7,541 people ages 65 and older died in motor vehicle crashes. It is estimated that more than 185,824 adults ages 65 and older were treated in emergency departments for nonfatal injuries as occupants in motor vehicle crashes during 2004 (WISQARS 2006).
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Suicide rates increase with age and are very high among those 65 years and older. In 2003, 5,248 Americans over age 65 committed suicide (WISQARS 2006).
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Older adults ages 65 and older are at an increased risk of dying in a residential fire; in 2003, 985 older adults died in home fires (WISQARS 2006).
The Cost
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In 2000, adults aged 75 years and older represented 5% of the population and 6% of all injuries, yet they accounted for 16% ($12.6 billion) of the lifetime medical costs for injuries that occurred that year (Finkelstein 2006).
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Hospitalized injuries accounted for 76% of the injury-attributable medical costs among people aged 75 years and older injured in 2000 (Finkelstein 2006).
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Females account for nearly 51% of the total lifetime costs of injuries for persons aged 65 to 74 years injured in 2000 and nearly 69% of the total lifetime cost of injuries for persons age 75 years and greater injured that year (Finkelstein 2006).
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Falls result in the greatest total lifetime costs among adults ages 65 and older injured in 2000, more than $19 billion (Finkelstein 2006).
Preventing Injuries among Older Adults
CDC is conducting research and programs to identify effective prevention strategies for reducing the burden of unintentional and violent injuries among older adults. Information about CDC efforts to prevent injuries and violence can be found at www.cdc.gov/injury; a few of these interventions are highlighted here:
Older Adult Falls Prevention
CDC has released new educational materials to help older adults prevent falls. Check for Safety: A Home Fall Prevention Checklist for Older Adults helps people to identify possible fall hazards and suggests solutions in each room of their home. What You Can Do to Prevent Falls focuses on the four key messages: begin a regular exercise program, have your health care provider review your medicines, have your vision checked, and make your home safer. New posters that promote these four fall prevention activities are also available. These materials can be found online in English, Spanish, and Chinese at
www.cdc.gov/ncipc/pub-res/toolkit/brochures.htm.
Smoke alarm installation and fire-safety education
Since 1998, CDC has funded smoke alarm installation and fire safety education programs in high-risk communities梩hose with fire death rates higher than state and national averages and median household incomes below the poverty level. An informal sample of program homes found that
1,053 lives have been saved thus far. Program staff have canvassed more than
380,047 homes and installed almost 269,990 long-lasting smoke alarms in high-risk homes, targeting households with children ages five years and younger and adults ages 65 years and older. Fire safety messages have reached millions of people as a result
of these programs. CDC funded 14 states from 1998 to 2000. Based on the success of these programs, CDC awarded funding to 13 states in 2001 to install long-lasting, lithium-powered smoke alarms and to provide fire-safety education in homes in high-risk communities. In 2002, 3 additional states were funded for these activities, bringing the total number of CDC-funded states to 16. For more information about preventing residential fires visit http://www.cdc.gov/ncipc/factsheets/fire.htm.
Developing a National Violent Death Reporting System
Currently CDC funds seventeen states as part of the National Violent Death Reporting System (NVDRS). These states gather, share, and link state-level data about violence from medical examiners, coroners, police, crime labs, and death certificates. NVDRS enables CDC and states to access vital, state-level information to gain a more accurate understanding of the problem of violence. This will enable policy makers and community leaders to make informed decisions about violence prevention strategies and programs. For more information about the National Violent Death Reporting System visit
www.cdc.gov/ncipc/profiles/nvdrs/facts.htm.
References
Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. American Journal of Public Health 1992;82(7):1020�
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. [cited 2006 Apr 5]. Available from URL: www.cdc.gov/ncipc/wisqars.
Finkelstein EA, Corso PS, Miller TR, Associates. Incidence and Economic Burden of Injuries in the United States. New York: Oxford University Press; 2006.
Hausdorff JM, Rios DA, Edelber HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Archives of Physical Medicine and Rehabilitation 2001;82(8):1050�
Hornbrook MC, Stevens VJ, Wingfield DJ, Hollis JF, Greenlick MR, Ory MG. Preventing falls among community-dwelling older persons: Results from a randomized trial. The Gerontologist 1994:34(1):16�.
Murphy SL. Deaths: Final data for 1998. National Vital Statistics Reports, vol. 48, no. 11. Hyattsville (MD): National Center for Health Statistics; 2000.
Sterling DA, O'Connor JA, Bonadies J. Geriatric falls: injury severity is high and disproportionate to mechanism. Journal of Trauma-Injury Infection and Critical Care 2001;50(1):116�
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