Unintentional Fall Injuries Data in North Carolina 2022

NC DEPARTMENT OF HEALTH AND HUMAN SERVICES Unintentional Fall Injuries in North Carolina 2022 Division of Public Health Data updated October 2, 2024

Unintentional Falls Technical Notes Surveillance methods have been updated to identify any mention of an injury in our morbidity data sources. Individual records with multiple injuries listed will be included in the total for each of those injuries, but only counted once for overall total injury count. Previously, only the first listed injury was counted, which has resulted in an increase in the number of specific injuries identified. For questions or for more information see technical notes document available at https://www.injuryfreenc.ncdhhs.gov/DataSurveillance/ Case Definitions used: Deaths ICD10 code W00-W19 listed cause of death NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 2

Technical Notes, Continued Hospitalizations Among records with an ICD-10-CM injury code*, any mention of the CD-10-CM codes below (includes records resulting in death) Emergency Department Visits Any mention of the ICD-10-CM codes below: (includes records resulting in hospitalization or death) Falls related to pedestrian conveyance Falls V00.11-V00.89 with 6th character=1 W00-W15, W17, W19 Fall, jump, or diving into water W16 with 6th character=2 (Except 16.4 and 16.9 with 5th character=2) W18.1, W18.2, W18.3 Other falls 7th character of A or missing (reflects initial encounter, active treatment) *See technical notes document for a full list of ICD-10-CM injury diagnosis codes NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 3

The populations most at risk of falls are projected to have the fastest growth over the next 20 years 2022 Population 2042 Population Percent Change 2022-2042 Overall increase of 24% N=13,242,528 N=10,705,403 0-17 17% 0-17 21% 0-17 20% 18-44 19% 18-44 18-44 36% 34% 45-59 45-59 22% 45-59 19% 19% 60+ 60+ 39% 60+ 27% 24% 65+ 65+ 21% 48% 65+ 18% 85+ 3% 85+ 114% 85+ 2% Source: North Carolina OSBM, Standard Population Estimates, Vintage 2021 & Population Projections, Vintage 2022 NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 4

Most older adults in NC are non-Hispanic White White* 77% Black* 17% American Indian/ Alaskan Native* 1% Asian* 2% Hispanic 3% *Non-Hispanic Source: National Center for Health Statistics, 2022; ages 65 and older NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 5

Demographic characteristics among older adults in North Carolina Veterans 16% 43% Speak English less than "very well" 3% Have a disability 34% of housing units with people 65 and older are single person households Have less than high school 13% Have high school education/GED 30% In the labor force 17% Income below poverty level (PL) 10% Income 100%-149% of PL 10% Source: American Community Survey, 2022 5-year estimates. Table S0103: Population 65 and older NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 6

One in five older adults in NC reports trouble walking 21% Ambulatory 13% Independent living 14% Hearing 8% Cognitive 7% Self-care 6% Vision Source: American Community Survey, 2022 5-year estimates. Table S1810: Population 65 and older NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 7

Around 40% of older adults in NC have one or more chronic diseases 1 or more chronic disease 2 or more chronic disease 1 chronic disease 82% 65-74 56% 27% 86% 75+ 58% 27% Source: NC State Center of Health Statistics, 2022 Behavioral Risk Factor Surveillance System (BRFSS) Survey Results NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 8

Proportion of demographic groups reporting two or more falls in the last 12 months, 2020 BRFSS Overall 13% Overall 13% Male Female 45-54 55-64 65-74 75+ 12% 14% 10% 12% 14% Veteran 15% 13% 11% 12% 15% Non-Veteran Urban Suburban Rural 19% 22% Social Vulnerability Least vulnerable (1st Quartile) to < Highschool Highschool/GED Some post College Grad Disability No Disability 13% 13% 1st Quartile 2nd Quartile 3rd Quartile 4th Quartile 12% 13% 13% 14% 9% 28% 5% Source: NC State Center of Health Statistics, 2022 Behavioral Risk Factor Surveillance System (BRFSS) Survey Results NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 9

Unintentional fall-related deaths are the tip of the iceberg 1,846* Deaths Despite NC s excellent reporting systems, the totalburden of fall injury in the state is unknown. 25,727* Hospitalizations 221,168* ED Visits ? EMS ? Outpatient Visits ? Medically Unattended Injuries INJURY ICEBERG INJURY ICEBERG INJURY ICEBURG INJURY ICEBURG Limited to NC Residents, 2022 Source: NC State Center for Health Statistics, Vital Statistics-Deaths (2022) and Hospitalization Discharge Data (2022); NC DETECT (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 10

Unintentional Fall Deaths

Unintentional fall-related deaths have continued to increase over the last 10 years Number of Deaths 1,846 2,000 1,800 1,600 1,400 1,200 989 1,000 87% increase 800 600 400 200 0 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 Limited to NC Residents, 2013 2022 Source: NC State Center for Health Statistics, Vital Statistics-Deaths (2013 2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 12

second Unintentional falls were the leading cause of injury death* in 2022 Poisoning - Unintentional Fall - Unintentional MVT - Unintentional Firearm - Self-Inflicted Firearm - Assault Suffocation - Self-Inflicted Suffocation - Unintentional Poisoning - Self-Inflicted Unspecified - Unintentional Fire/Burn - Unintentional All Other Injury Deaths 4,199 1,846 1,796 993 777 331 218 195 165 138 922 *by mechanism and intent MVT = Motor Vehicle Traffic Limited to NC Residents, 2022 Source: NC State Center for Health Statistics, Vital Statistics-Deaths (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 13

number one Unintentional falls were the cause of injury death among older adults* 88% of fall-related deaths Number of Deaths 900 814 800 700 567 600 500 400 242 300 144 200 41 100 19 15 2 1 1 0 0 0 0 <1 01-04 05-09 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 >84 Age Group *Adults ages 65 and older Limited to NC Residents, 2022 (N = 1,846) Source: NC State Center for Health Statistics, Vital Statistics-Deaths (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 14

Unintentional fall death rates are highest among those ages 85 and older Rate per 100,000 470.3 500 450 400 Rates begin increasing among ages 45-54 350 300 250 200 150 101.0 100 10.5 21.9 3.0 50 1.4 1.0 0.0 * 0.0 * 0.0 * 0 <1 01-04 05-09 10-14 15-19 20-24 25-34 Age Group 35-44 45-54 55-64 65-74 75-84 >84 *Rate suppressed due to count being less than 5 Limited to NC Residents, 2022 (N = 1,846) Source: NC State Center for Health Statistics, Vital Statistics-Deaths (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 15

Most fall-related deaths occurred among women and non-Hispanic Whites Number of Deaths 1800 1,576 1600 1400 1200 946 900 1000 800 600 400 185 200 41 23 13 8 0 Female Male AI/NA NH Asian NH Black NH Hispanic White NH Other NH NH - non-Hispanic; There were 0 deaths where the race/ethnicity was unknown Limited to NC Residents, 2022 (N = 1,846) Source: NC State Center for Health Statistics, Vital Statistics-Deaths (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 16

Unintentional Fall Hospitalizations

Unintentional fall-related hospitalizations increased by over the last five years 7% Number of Hospitalizations 30,000 25,727 24,056 25,000 20,000 7% increase 15,000 10,000 5,000 0 2018 2019 2020 2021 2022 Limited to NC Residents, 2018 2022 Source: NC State Center for Health Statistics, Hospitalization Discharge Data (2018 2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 18

78% of fall-related hospitalizations occurred among adults 65 and older Number of Hospitalizations 9,000 7,651 8,000 6,916 7,000 5,456 6,000 5,000 4,000 2,776 3,000 2,000 1,109 639 461 1,000 139 133 121 114 107 105 0 <1 01-04 05-09 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 Age Group >84 Age was unknown for 0 hospitalizations Limited to NC Residents, 2022 Source: NC State Center for Health Statistics, Hospitalization Discharge Data (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 19

Adults have the highest rates of fall-related hospitalizations 85 and older Rate per 100,000 4,500 3,995.4 4,000 3,500 3,000 2,500 2,000 1,500 1,362.7 1,000 86.7 25.2 18.0 15.9 19.5 18.6 32.1 47.1 82.2202.6 492.7 500 0 <1 01-04 05-09 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 Age Group >84 Age was unknown for 0 hospitalizations Limited to NC Residents, 2022 Source: NC State Center for Health Statistics, Hospitalization Discharge Data (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 20

Most fall-related hospitalizations occurred among women and non-Hispanic Whites Number of Hospitalizations 25,000 21,363 20,000 15,943 15,000 9,783 10,000 5,000 2,775 747 211 200 185 0 Female Male AI/NA NH Asian NH Black NH Hispanic White NH Other NH NH non-Hispanic Sex was unknown for 1(<0.1%) injury hospitalizations and race/ethnicity was unknown for 246(0.1%) injury hospitalizations Limited to NC Residents, 2022 Source: NC State Center for Health Statistics, Hospitalization Discharge Data (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 21

Fall-related hospitalization rates were highest among women and non-Hispanic Whites Rate per 100,000 327.2 350.0 291.7 300.0 250.0 187.1 180.7 200.0 150.0 123.2 100.0 62.5 49.5 50.0 0.0 Female Male AI/NA NH Asian NH Black NH Hispanic White NH NH non-Hispanic Sex was unknown for 1(<0.1%) injury hospitalizations and race/ethnicity was unknown for 246(0.1%) injury hospitalizations Limited to NC Residents, 2022 Source: NC State Center for Health Statistics, Hospitalization Discharge Data (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 22

Unintentional Fall Emergency Department Visits

Unintentional fall-related ED visits remain high, but decreased over the last five years 2% Number of ED Visits 250,000 225,837 221,168 200,000 150,000 2% decrease 100,000 50,000 0 2018 2019 2020 2021 2022 Limited to NC Residents, 2018 2022 Source: NC DETECT (2018 2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 24

50% of fall-related ED visits occurred among adults 65 and older Number of ED Vistis 45,000 40,910 40,000 37,057 35,000 31,537 30,000 27,562 25,000 20,000 17,687 11,88112,808 15,000 10,869 8,449 10,000 7,456 5,512 5,442 3,342 5,000 0 <1 01-04 05-09 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 >84 Age Group Age was unknown for 656 ED Visits Limited to NC Residents, 2022 Source: NC DETECT (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 25

Adults have the highest rates of fall-related ED Visits 85 and older Rate per 100,000 20,000 18,219.3 18,000 16,000 14,000 12,000 10,000 7,286.6 8,000 6,000 3,346.3 4,000 2,758.6 2,261.6 2,011.7 1,331.1 1,310.5 1,109.6 2,000 943.2 826.0 772.7 759.8 0 <1 01-04 05-09 10-14 15-19 20-24 25-34 Age Group 35-44 45-54 55-64 65-74 75-84 >84 Age was unknown for 656 ED Visits Limited to NC Residents, 2022 Source: NC DETECT (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 26

Most fall-related ED visits occurred among women and non-Hispanic Whites Number of ED Visits 180,000 158,471 160,000 131,226 140,000 120,000 89,437 100,000 80,000 60,000 42,002 40,000 10,071 20,000 4,414 1,939 1,540 0 Female Male AI/NA NH Asian NH Black NH Hispanic White NH Other NH NH - non-Hispanic; sex was unknown for 505(<0.1%) injury ED visits and race/ethnicity was unknown for 2,731(<0.1%) injury ED visits Limited to NC Residents, 2022 Source: NC DETECT (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 27

Rates of fall-related ED visits were highest among women and non-Hispanic Whites Rate per 100,000 3,000 2,427 2,401 2,500 1,864 2,000 1,752 1,710 1,500 843 1,000 412 500 0 Female Male AI/NA NH Asian NH Black NH Hispanic White NH NH - non-Hispanic; sex was unknown for 505(<0.1%) injury ED visits and race/ethnicity was unknown for 2,731(<0.1%) injury ED visits Limited to NC Residents, 2022 Source: NC DETECT (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 28

Leading diagnosis codes for fall-related ED Visits 57.6% Unspecified fall 10.9% Fall on same level from slipping, tripping and stumbling without subsequent striking against object 4.9% 4.2% 3.3% 2.8% 2.7% 2.0% 1.2% 1.1% 1.1% 1.0% 0.8% 0.7% 0.6% 5.2% Fall on same level, unspecified Fall on same level from slipping, tripping and stumbling with subsequent striking against other object Other fall on same level Fall from bed Fall (on) (from) unspecified stairs and steps Other fall from one level to another Fall (on) (from) other stairs and steps Fall on and from ladder Fall from chair Fall on same level from slipping, tripping and stumbling with subsequent striking against unspecified object Fall in (into) shower or empty bathtub Fall on same level from slipping, tripping and stumbling with subsequent striking against furniture Fall from non-moving wheelchair All Other Injury Deaths Limited to NC Residents, 2022 Source: NC DETECT (2022) Analysis by Injury Epidemiology and Surveillance Unit NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 29

Summary of unintentional fall-related injuries in North Carolina In 2022, unintentional fall-related injuries resulted in: Almost deaths Nearly hospitalizations Over emergency department visits Most falls occur among females and Non-Hispanic whites Rates of fall-related injuries are highest in the 75-84 and 85 and older age groups 2,000 26,000 220,000 NCDHHS, Division of Public Health | Unintentional Motor Vehicle Traffic Injuries in NC, 2022 30

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Questions? InjuryData@dhhs.nc.gov Injury and Violence Prevention Branch NC Division of Public Health www.injuryfreenc.dph.ncdhhs.gov