The study, “Leisure-Time Physical Activity, Falls, and Fall Injuries in Middle-Aged Adults,” published online in the American Journal of Preventive Medicine, focused on adults ages 45 to 64 as they are often perceived as less vulnerable to falls and related injuries than seniors, and so do not receive preventive interventions. However, the research revealed that falls are not only costly but are the third leading cause of accidental death among middle-aged Americans.
“We know a lot in the scientific literature about fall-related injuries among seniors and the risk for death, but we knew very little about the prevalence of falls among the middle-aged and how exercise prevented falls among this group,” said Alberto Caban-Martinez, D.O., Ph.D., M.P.H., assistant professor of public health sciences, Director of the musculoskeletal disorders and occupational health lab and Associate Director of the Miami Occupational Research Group. “This new research data is pertinent as it sets the basis for the health community to develop prevention interventions specific to middle-aged Americans.”
The results also have wider implications for health care savings as injuries can require emergency hospital care and long-term disability care. In fact, the study also found that injuries that occurred in a home setting cost an overall $217 billion, with falls representing the largest portion, or 42 percent of the total cost of those injuries.
The study, conducted in 2014, analyzed national data from the Centers for Disease Control and Prevention’s 2012 U.S. Behavioral Risk Factor Surveillance Survey, which contains findings on the incidence of falls and fall-related injuries among U.S. adults who stated that they needed to limit their activity for a day to see a doctor. The self-reported falls took place within three months prior to the survey. Of the 340,680 people examined, those between the ages of 45 and 64 who engaged in physical activity had significantly fewer falls and injuries (about 6 to 7 percent) than adults of the same age group who did not engage in exercise or other physical activity.
“If you think about this, the study sample size was about 300,000 adults 45 years and older representing 122 million Americans, so 6 or 7 percent equates to about 18,000 who have reduced their risk of falling by being intentional about their physical activity,” said Caban-Martinez, who in addition to his ergonomics practice at the University of Miami Miller School of Medicine is an occupational epidemiologist whose research has focused on work-related health trends. “With adequate education and prevention measures, imagine the number of other adults who could protect themselves against falls and injuries.”
The study evaluated other risk factors for falls and fall-related injuries in middle-aged adults, concluding that higher household income was protective against falls and injuries resulting from a fall. Lower household income is associated with poorer living environments, poor health behaviors, and barriers to health care services, which may in turn affect health status and increase the risk of falling. Among health-related factors, cardiovascular disease, diabetes status and alcohol use were associated with falls and fall-related injuries in middle-aged adults.
“Dr. Caban-Martinez’s findings are extremely important because they can guide policy makers on ways to increase physical activity to prevent falls, particularly among the poor,” said José Szapocznik, Ph.D., professor and Chair of the Department of Public Health Sciences and Director of the Miami Clinical and Translational Science Institute. “We know that the poor have less opportunity to exercise and access to gyms than middle class individuals.”
Szapocznik also pointed to previous research conducted by UM, showing that the nature of the neighborhoods in which people live may also influence their level of physical activity. One study revealed that mixed-use neighborhoods with residential settings within close range or walking distance to retail shops and other destinations tend to promote walking. Sprawling communities where retail and other essential destinations are less accessible by foot were found to discourage walking.
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