Prevention of Unintentional Injuries Among Seniors

Workshop on Healthy Aging:
November 28-30, 2001

Gaps and Challenges

Coordination

Currently, there is no central program that integrates injury prevention activities within Health Canada or the federal government as a whole. The Health Canada Injury Prevention Working Group was established to improve networking and coordination within the department. Health Canada has also assumed the lead in other federal strategies addressing specific aspects of the injury issue (e.g. the Family Violence Prevention Initiative). Health Canada is also working toward strengthening cooperation with partners such as the Canadian Agriculture Safety Program.

Research and knowledge development

Identifying and addressing gaps in knowledge about this issue is hampered by:

• a lack of research funding

• a shortage of researchers in Canada who have an injury focus and the epidemiological expertise to use existing data

• a lack of standardization of information on patterns of injury; namely, a minimum data set for injury surveillance

• isolation of injury prevention researchers and practitioners. This situation is improving with the creation of the Canadian Collaborating Centres on Injury Prevention and the Canadian Injury Research Network.

Programs and interventions

Preventing injuries through direct intervention is hampered by a lack of:

• networking and communications among practitioners

• information about existing programs and resources Healthy Aging 12 Injury Prevention

• funding to sustain injury prevention programs o knowledge of how to secure potential funding

• knowledge of effective programs

• knowledge of how to access and analyze injury data.

Capacity building

Overall coordination and collaboration among stakeholders and across sectors has been lacking (e.g. provincial networks of stakeholders are not comprehensive, as seniors' injuries are often not given priority). However, this situation is changing quickly.

A Population Health Fund project in the British Columbia region was effective in building an adult injury prevention network in the province. In addition, Health Canada and Veterans Affairs Canada have come together to form the Falls Prevention Initiative, a community-based health promotion effort to help identify effective fall prevention strategies for veterans and seniors. Veterans Affairs Canada has committed $10 million over a four-year period to pilot approved projects at the national level and in three regions: Atlantic Canada, Ontario and British Columbia. The funds are being distributed through Health Canada's Population Health Fund. One of the key objectives of this initiative is to develop the capacity of veterans and other community organizations to develop and deliver sustainable community-based health promotion programs addressing falls prevention using the population health approach.

Practitioners in health, social services and recreation often lack specific training in injury prevention and may not understand the multifactorial nature of injuries. There are also many groups in the private sector that have a significant role to play in the prevention of injuries. However, many of these key players do not see themselves in this role. A current project in Alberta to develop and test an injury prevention curriculum may assist in addressing this problem.

Public and political support for the issue

There is a strong degree of interest and activity in the non-governmental sector. Over the past few years, many groups have called on the federal government to establish a national injury prevention strategy that encompasses all injuries and all age groups. Government and nongovernmental groups that have taken particular interest in seniors' injuries include Smartrisk; the University of Victoria; Community Health Research Unit of the University of Ottawa; Alberta Centre for Injury Research and Control; BC Injury Research and Prevention Unit; Canada Standards Association International; federal, provincial and territorial Ministers Responsible for Seniors; and federal, provincial and territorial Deputy Ministers of Health.

In the Speech from the Throne, injury prevention was identified as a priority area for government action.

In September 1999, the federal, provincial and territorial Ministers Responsible for Seniors directed their officials to undertake the following activities:

• Disseminate to all levels of government the reference document Enhancing Safety and Security for Canadian Seniors, which was prepared for Ministers.

• Evaluate current fall prevention programs and practices and disseminate the Healthy Aging 13 Injury Prevention findings.

• Investigate the costs and implications of strengthening injury prevention data on seniors.

• Work with key organizations to ensure that building codes and product standards address the safety needs of seniors.

Recommended Strategies for an Action Plan on Healthy Aging:

Coordination of leadership and policy

An effective process within Health Canada is essential to ensure that the problem of seniors' injuries is fully addressed and that key stakeholders are fully engaged. In particular, leadership is needed to coordinate policies and programs for injury prevention across government jurisdictions, such as those with responsibility for building codes, product standards, housing and health care.

Research and knowledge development

There is a need to increase the allocation of research dollars for injury prevention to accurately reflect the economic burden of injury. Currently, the total of Canadian research dollars allocated to injury is almost inverse to the total direct and indirect costs of injury. A review of the literature provides an indication of some of the gaps in knowledge regarding seniors' injuries, particularly for causes of injuries other than falls; however, there has yet to be a process to determine priority areas of research. Thus, Health Canada would benefit from the development of an injury research agenda, as has been done in other countries, which would seek to reduce gaps in research knowledge, ensure an appropriate breadth and quality of research skills, and identify emerging areas where injury risks can be reduced.

While there are limited data on the incidence of seniors' injuries, it is not clear whether the lack of information is strictly a function of a limited surveillance system or if there is also an underutilization of existing data, namely a need for research studies using current data in order to identify appropriate interventions.

Programs and interventions

The dissemination of information on intervention methods that are known to be effective must be improved. Interventions should be evaluated.

Capacity building

The development of a national network of seniors' injury stakeholders should be supported. As the issue of injury prevention moves forward, it is crucial that there be a strong voice to ensure that seniors' concerns are addressed equally.

Legislation and regulation

Building codes play an important role in injury prevention. Data from CHIRPP identified that construction features of a house or building, such as stairs, floors and steps, are indicated in seniors' falls more often than any household product. For example, in Canada, persons 65 years of age or older account for 70% of the deaths resulting from stair accidents. Building codes are the jurisdiction of provinces and territories; however, the National Building Code, a federal responsibility, often sets the standard and therefore should include features that are known to prevent injuries.

Finally, many products have not been designed to take into account the physical changes that may occur with the aging process. Thus, there is a need for product standards or guidelines that take into account the needs of all age groups, including seniors.

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