Prevention of Unintentional Injuries Among Seniors

Workshop on Healthy Aging:
November 28-30, 2001

A. Overview of the Issue

Significance of the Issue

Unintentional injuries among seniors are a major public health problem that has received relatively little attention compared to other age groups and to other health problems. Injuries to seniors are costly to the health care system and often have serious consequences to seniors themselves. Many injuries lead to an irreversible decline in function, institutionalization and even death. The annual direct and indirect costs related to unintentional injuries for all Canadians are estimated at $8.7 billion. In 1994, those 71 years of age or older accounted for over 27% of all unintentional injuries resulting in hospitalization and 34% of the deaths resulting from unintentional injury.

Of all the causes of seniors' injuries, falls are by far the biggest problem, accounting for over 87% of unintentional injuries resulting in hospitalization for those 71 years of age or over, and 75% of the deaths resulting from injury. For Canadians 65 years of age or older, direct and indirect cost to the health care system for fall-related injuries alone is estimated at $2.8 billion annually. The other leading causes of unintentional injury for seniors are motor vehicle crashes, poisoning, drowning, suffocation and fires. Falls and other causes of unintentional injuries are not the result of accidental events but are predictable. The risk factors are identifiable and there are preventive interventions available that can eliminate or minimize their impacts.

Magnitude of the Problem

While seniors comprise only 12% of the Canadian population, they account for 35% of all injury hospitalizations. In addition to the substantial economic costs of seniors' injuries, the impact to their loss of independence is also considerable. It is estimated that 20% of seniors who enter a hospital for treatment of an injury are moved from their private residences to institutionalized care.

Approximately one million, or one in every three seniors living in the community, will experience at least one fall per year, and up to 50% of these individuals will experience repeated falls. These numbers are even higher for seniors living in institutional settings.

The issue of older drivers in Canada and injuries and fatalities due to motor vehicle crashes has been receiving increasing attention. An examination of absolute numbers suggests that older drivers have fewer collisions than younger people. However, according to an Ontario study, on the basis of kilometres driven, older drivers get into approximately the same number of motor vehicle crashes as those 16 to 24 years of age. While the research on the risk that older drivers pose is not conclusive, it is known that seniors are more likely to die from their injuries or take longer to recover. In 1996, although seniors represented 11% of the population, they accounted for 18% of all fatalities and 6% of injuries occurring on Canadian roadways (this includes older passengers and pedestrians as well as drivers).

An Alberta study found that unintentional deaths due to house fires among those 80 years of age or older were the highest for all age groups at 3.2 per 100,000 per year, with children aged 0 to 4 the next highest at 2.9 per 100,000 per year. While the contributors to most fires were found to be multifactorial, cigarettes or other smoking products were involved in 33% of the fires and alcohol consumption in 59%.

Seniors, children and persons with disabilities account for approximately 85% of the burns due to scalding. Scalds often occur among frail seniors due to exposure to excessively hot water in bathtubs and showers, as their skin has reduced sensitivity to temperature and they cannot get out of harm's way quickly.

The picture of injuries differs for specific populations of seniors, such as those living on farms and Aboriginal people. The significant problem of injuries for seniors living on farms has been demonstrated in a recent report on fatal farm injuries in Canada. This report identified seniors, in particular males over the age of 60, as one of the high-risk groups for farm fatalities - the other high-risk group being children. To illustrate, although farm-dwelling seniors between the 70 and 79 years of age make up only 3.2% of the farm population, they account for 17.8% of farm work-related deaths and 20% of hospitalized injury cases.

Aboriginal people experience three times the injury death rate of Canadians as a whole. Among this population, the most common cause of death from injury is motor vehicle crashes, suicide and accidental drug overdose. Although Aboriginal people comprise only 3% to 5% of the Canadian population, they account for 26% of snowmobile drownings, 16% of drownings from falls into water, 10% of drownings during aquatic activities and 9% of boating drownings. In British Columbia, the age standardized mortality rate for deaths due to fall-related injury is three times that of the provincial average.

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