Fatal Brain Injuries From Falls Rose 17% in a Decade, 2008–2017

One in 10 U.S. adults reports a fall every year. At any age, falls can cause serious injuries, and they are the second leading cause of deaths from traumatic brain injury (TBI) — a disruption of normal brain function from a bump, blow or jolt to the head or body, or from a penetrating head wound.

CDC used death certificates from all 50 states and the District of Columbia to track deaths from TBIs caused by unintentional falls from 2008 to 2017.

A steady rise

• Comparing just 2008 and 2017, the number of deaths rose in 49 of 51 jurisdictions, and the rate in 45 of those 49.
• Over the decade, rates rose significantly in 29 states: Arkansas, California, Colorado, Connecticut, Florida, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Virginia and Wisconsin. The other 21 states and DC saw no significant change.
• The fastest average yearly increases were in Maine (6.5%), South Dakota (6.1%) and Oklahoma (5.2%).

Age-adjusted rates of TBI deaths caused by unintentional falls, by state, 2008 and 2017. CDC

Who is dying

• Rates rose significantly from 2008 to 2017 for both sexes, everyone 55 and older, White, Black and Hispanic people, and in every kind of community, urban to rural.
• The biggest rises were among people in the most rural (noncore) counties (an average 2.9% a year) and people 75 and older (2.6% a year).
• The only group whose rate fell was children and teens 0–17 (−4.3% a year).

Why

• Rural gaps. Rural areas have higher TBI death rates, and uneven access to high-level trauma centers and rehabilitation can worsen outcomes.
• Men may more often fall from heights, such as ladders, suffering more severe injuries.
• Age is a major risk factor for falls. The national rise may reflect people living longer with diseases such as stroke, cancer and heart disease, and a growing population of older adults.
• An earlier CDC report found a similar 22% rise over 2006–2014.

Preventing falls

Health care providers can educate patients about falls and TBI, assess fall risk, and refer people to evidence-based fall prevention programs. CDC's STEADI initiative (Stopping Elderly Accidents, Deaths, & Injuries) helps them screen older patients, find risks that can be changed and act on them — for example by prescribing balance, strength and gait exercises such as tai chi, and reviewing medicines linked to falls. Annual wellness visits are a chance to revisit risks and update prevention plans.

Everyone can:

• talk to a provider about their own — or their parents' — risk of falling;
• do strength and balance exercises;
• get a yearly eye exam;
• make the home safer, for example by removing tripping hazards.

Limits

Causes of death may be misclassified or incompletely recorded; race and ethnicity are often misclassified on death certificates, especially for American Indian/Alaska Native, Asian/Pacific Islander and Hispanic people; and where there were several injuries, others besides the TBI may have contributed to death.

Sources

Based on Peterson AB, Kegler SR, "Deaths from Fall-Related Traumatic Brain Injury — United States, 2008–2017," MMWR volume 69, number 9, Centers for Disease Control and Prevention; a work of the United States government in the public domain.