A socio-spatial analysis of pedestrian falls in Aotearoa New Zealand.

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Date: Nov. 2021
From: Social Science & Medicine(Vol. 288)
Publisher: Elsevier Science Publishers
Document Type: Report
Length: 449 words

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Abstract :

Keywords Older adults; Outdoor falls; Pedestrian falls; Geospatial analysis; Environmental characteristics Highlights * Older adult pedestrians fall closer to home than younger adults. * Pedestrian falls occur at a higher rate in more deprived areas. * Younger and older adult pedestrians fall in different built environments. Abstract Falls are a leading cause of injury and accidental death, particularly amongst older people. Evidence of environmental risk factors for pedestrian falls among older adults could support age-friendly urban design and contribute to efforts to reduce the incidence of pedestrian falls and support outdoor mobility among older adults. Yet investigation of the environment in which pedestrian falls occur is often hampered by its reliance on participant recall and self-report information. We identified the point locations of falls occurring on the road or street among adults that were attended by an ambulance in New Zealand over a two-year period (2016--2018) and connected these to a range of social (e.g. deprivation) and environmental (e.g. slope, greenspace) risk factors. Three types of analysis were used: a descriptive analysis of fall rates, logistic regression assessing whether a patient was transported to hospital following a fall, and a negative binomial regression analysis of the pedestrian falls by small area. We found a number of differences in the built environment surrounding fall locations between age groups. Compared with younger age groups, older adults showed high fall rates closer to home, and higher fall rates in areas with many types of destinations nearby. Additionally, our results showed a higher rate of pedestrian falls in more deprived areas. People who live in more deprived areas also fell over more frequently, but the pattern is stronger based on deprivation at the fall location, rather than home location. Residents of more deprived areas were less likely to be transported to hospital following a fall. Thus, our findings have equity implications for both environments and patient experience. These patterns could not have been identified without the novel use of spatially specific fall data. Author Affiliation: (a) School of Earth and Environment, University of Canterbury, New Zealand (b) Department of Population Health, University of Otago Christchurch, New Zealand (c) Melbourne School of Population and Global Health, University of Melbourne, Australia (d) GeoHealth Laboratory, University of Canterbury, New Zealand (e) Clinical Audit and Research, St John, New Zealand (f) Paramedicine Department, Auckland University of Technology, New Zealand * Corresponding author. Department of Population Health, University of Otago Christchurch, PO Box 4345, Christchurch, New Zealand. Article History: Revised 11 June 2020; Accepted 8 July 2020 (footnote)1 Present address: Department of Population Health, University of Otago Christchurch. Byline: A. Watkins [alison.watkins@otago.ac.nz] (a,*,1), A. Curl (b), S. Mavoa (c), M. Tomintz (d), V. Todd (e,f), B. Dicker (e,f)

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Gale Document Number: GALE|A679455823