Health Highlight Report for Sierra County
Injury - Older Adult Falls Deaths: Deaths per 100,000 Population, 2013-2017
Sierra County122.4 95% Confidence Interval(73.4 - 171.3)Description of the Confidence IntervalThe confidence interval indicates the range of probable true values for the level of risk in the community.
A value of "DNA" (Data Not Available) will appear if the confidence interval was not published with the IBIS indicator data for this measure.
Statistical StabilityStableDescription of Statistical Stability
- Stable = This count or rate is relatively stable and should provide a good estimate of your community risk.
- Unstable = This count or rate is statistically unstable (RSE >0.30), and may fluctuate widely due to random variation (chance).
- Very Unstable = This count or rate is extremely unstable (RSE >0.50). This value should not be used to represent your population risk. You should combine years or otherwise increase the population denominator in this calculation.
- DNA = Data Not Available. The required community value and/or confidence interval was not available for this measure.
New Mexico91.1 U.S.59.4
Sierra County Compared to State
Description of Dashboard Gauge
Description of the Dashboard GaugeThis "dashboard" type graphic is based on the community data on the right. It compares the community value on this indicator to the state overall value.
The community value is considered statistically significantly different from the state value if the state value is outside the range of the community's 95% confidence interval. If the community's data or 95% confidence interval information is not available, a blank gauge image will be displayed with the message, "missing information."NOTE: The labels used on the gauge graphic are meant to describe the community's status in plain language. The placement of the gauge needle is based solely on the statistical difference between the community and state values. When selecting priority health issues to work on, a community should take into account additional factors such as how much improvement could be made, the U.S. value, the statistical stability of the community number, the severity of the health condition, and whether the difference is clinically significant.
- Excellent = The community's value on this indicator is BETTER than the state value, and the difference IS statistically significant.
- Watch = The community's value is BETTER than state value, but the difference IS NOT statistically significant.
- Improvement Needed = The community's value on this indicator is WORSE than the state value, but the difference IS NOT statistically significant.
- Reason for Concern = The community's value on this indicator is WORSE than the state value, and the difference IS statistically significant.
Why Is This Important?Falls are the leading cause of unintentional (accidental) injury death among adults aged 65 years and older in the United States and in New Mexico. The majority of fall-related injury deaths among older adults involve hip fractures and traumatic brain injuries. Non-fatal injuries from a fall can limit the mobility and also result in non-independent living for many older adults. Falls among older adults are associated with an increased risk of future fall-related injury associated premature death. Many people who fall develop a fear of falling and may become more sedentary, further increasing their risk for another fall. Most falls are not a normal part the normal aging process and are preventable.
How Are We Doing?The fall-related death rate among adults aged 65 years and older in New Mexico increased by 16% between 2015 and 2016.
What Is Being Done?As a result of legislation that was passed in 2013 and 2014, the New Mexico Department of Health expanded its adult falls prevention program, after which it received additional funding to more comprehensively establish older adult falls primary and secondary prevention programs. The Office of Injury Prevention has prioritized the following intervention efforts pursuant to its partnership with the NM Adult Falls Prevention Coalition (for more information see http://nmstopfalls.org). Older community-dwelling adults should increase safe physical activities, have medications reviewed annually, assure appropriate levels of Vitamin D intake, and make appropriate safety modifications to their homes. o Health care providers should screen their older adult patients for fall risk factors and refer them to appropriate interventions in order to minimize their fall risk. o Caregivers and family members should be trained on fall prevention strategies. o State agencies and other organizations should increase the availability of evidence-based falls prevention and physical activity programs in community-based organizations serving older adults improve mechanisms for health care providers to screen and refer older adults who may be at risk for falls to community-based falls prevention and physical activity programs, and empower all individuals to promote falls prevention strategies in their communities. PHYSICAL ACTIVITY: Evidence-based fall prevention exercise programs are an effective means for older adults to get stronger and improve their balance and have been demonstrated to reduce the risk of adult falls. The New Mexico Department of Health currently supports four evidence-based fall prevention programs for older adults: Otago, A Matter of Balance: (MOB), Tai Ji Quan: Moving for Better Balance, and Tai Chi for Arthritis. Otago has traditionally been for home-bound adults, however, recent movements in the program have proven it to be just as effective as a group or community-based program. A Matter of Balance: Managing Concerns about Falls, Tai J Quan, and Tai Chi for Arthritis are community-based programs commonly offered through senior citizen centers throughout New Mexico. The objectives of these evidence-based fall prevention programs are to increase level of safe physical activity, reduce fear of falls, and also to improve strength, balance, mobility, and daily functioning in older adults. There are currently over 94 evidence-based falls prevention instructors in 16 New Mexico counties and 14 Native American Pueblos who are available for teaching evidence-based fall prevention programs to adults who may be at risk for falls. In 2016 and 2017, approximately 500 older adults completed one or more evidence-based fall prevention program in New Mexico. CLINICAL INTERVENTION: The New Mexico Department of Health has sponsored peer-to-peer training for healthcare providers on clinical implementation of the Center for Disease Control and Prevention's (CDC's) fall prevention toolkit, Stopping Elderly Accidents, Deaths and Injuries (STEADI), which is used to screen for multiple risk factors for falls and provides for referrals to appropriate resources, including evidence-based falls prevention programs as appropriate. Screenings for fall risk may include identifying strength and balance issues, home safety modifications, review and manage medications linked to falls, annual vision checks, and vitamin D intake recommendations. HOME SAFETY MODIFICATION: Most falls happen at home. The New Mexico Department of Health (NMDOH) encourages older adults and their caregivers to check their homes for safety and modify as appropriate to minimize potential hazards. Home safety hazards can include torn rugs or rugs that do not lie flat, stairs that are in poor repair (i.e. broken or no handrails), poor lighting, and clutter on floors or in walkways. Another environmental safety concern for older adults may be the need for appropriate safety equipment for accessibility in the bathroom such as grab bars, a walk-in shower, and adaptive equipment as needed. The NMDOH encourages local services such as Fire Departments, and Emergency Medical Services (EMS) to do provide home visits to community members aged 65 years and older who may be at risk for falls and educate them about opportunities to make their homes safer.. Individuals who qualify for Medicaid or dual enrollment (Medicaid and Medicare) may qualify for environmental modification funds through their Managed Care Organization (MCO).
Evidence-based PracticesHow can older adults prevent falls*? Exercise regularly to increase strength and balance. The NMDOH currently supports four evidence-based falls prevention programs and Stopping Elderly Accidents, Deaths and Injuries (STEADI) as a clinical intervention and best practices for fall prevention. Ask a doctor or pharmacist to review medications annually, including both prescription and over-the-counter medications, to identify medications that may cause side effects, such as dizziness or drowsiness. Visit an Optometrist annually to update prescription eyeglasses and maximize vision. Reduce home hazards by removing tripping hazards, installing grab bars in the bathroom, both inside and outside the tub or shower and next to the toilet, installing railings on both sides of stairways, and improving all lighting in the home. *Source: Important Facts about Falls: What You Can Do To Prevent Falls, downloaded from http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html on November 23, 2015.
Healthy People Objective IVP-23.2:Prevent an increase in the rate of fall-related deaths: Adults aged 65 years and older
U.S. Target: 47.0 deaths per 100,000 population
Relevant Population Characteristics:
NoteRates are age-specific death rates for ICD-9 Codes: E880-E886, E888 (1990-1998) and ICD-10 codes ICD-10 Codes: W00-W19 (1999 forward).
Data SourcesNew Mexico Death Data: Bureau of Vital Records and Health Statistics (BVRHS), New Mexico Department of Health. New Mexico Population Estimates: University of New Mexico, Geospatial and Population Studies (GPS) Program, http://gps.unm.edu/. Centers for Disease Control and Prevention, National Center for Health Statistics, CDC WONDER Online Database (http://wonder.cdc.gov).
Measure Description for Injury - Older Adult Falls Deaths
Definition: Fall-related death rate is the number of unintentional injury deaths due to falls in persons age 65 years or older, per 100,000 population age 65 years or older.
Numerator: The number of unintentional injury deaths due to falls in persons age 65 years or older.
Denominator: The mid-year estimated population.