The Burden of Unintentional Falls

 

Unintentional falls are a leading cause of death and a major contributor to disability in the adult population in the Region of the Americas. It is also ranked as the 10th cause of years lived with disability in all-age population in the region. 

This data visualization presents estimates of the burden of falls (mortality and disability) by age, sex, and country in the Region of the Americas from 2000 to 2019.

Mortality

In the Region of the Americas: 

  • it is estimated that 80,546 deaths (95% UI: 65,822 to 95,041) were due to unintentional falls in 2019.
  • This number almost tripled since 2000 where 31,013 deaths (95% UI: 26,426 to 35,626) were estimated to occur. Falls are a particular concern for older people.
  • Both, crude and age-standardized death rates due to falls increased from 2000 to 2019.
  • The crude mortality rate increased from 3.74 deaths per 100,000 population in 2000 to 7.98 deaths per 100,000 population in 2019.
  • The age-standardized deaths rate increased from 3.58 deaths (95% UI: 3.1 to 4.1) per 100,000 population in 2000 to 5.40 deaths (95% UI: 4.4 to 6.4) per 100,000 population in 2019.
  • The age-standardized death rate due to unintentional falls was 7.1 deaths (95% UI: 5.9 to 8.5) per 100,000 population in men,, and 3.9 deaths (95% UI: 3.2 to 4.5) per 100,000 population. 

Top 20% of countries with high age-standardized death rates (more than 6 deaths per 100,000 population) in 2019

  1. Cuba
  2. Guatemala
  3. Bolivia
  4. Brazil
  5. Haiti
  6. Suriname
  7. Ecuador

Bottom 20% of countries with low age-standardized death rates (lower than 2.0 deaths per 100,000 population) in 2019

  1. Costa Rica
  2. Paraguay
  3. Guyana
  4. Barbados,
  5. Argentina
  6. Uruguay
  7. Antigua and Barbuda

In addition to deaths from falls, injuries including those requiring medical attention are an important concern. 

Injuries and deaths from unintentional falls can be prevented through evidence-based interventions. The Step Safely technical package provides concrete recommendations for evidence-based strategies to prevent and manage falls for children and adolescents, workers, and older people. Among others, effective prevention measures include parenting programs for low-income and marginalized families, stricter worker safety regulations, and strength and balance training for older people.
 

Suggested citation

PAHO. The burden of unintentional falls in the Region of the Americas, 2000-2019. Pan American Health Organization. 2021.

DATA CLASSIFICATION

In the map and horizontal bar chart, the data is presented in five classes created using the quantile classification method. Each class contains 20% of countries, which is easy to interpret. The quintile intervals are labeled sequentially from Quintile 1, also called the bottom quintile which includes the lowest fifth (0 to 20%) of data points to Quintile 5 (or top quintile), which includes the top fifth (80% to 100%) of data points.

INDICATOR DEFINITION

Measure: Death, Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLDs), and Years of Life Lost (YLLs) due to premature death.  

Metric: Rate

Unit of Measure: For mortality measures: deaths per 100,000 population. For measures of burden of disease: years per 100,000 population 

Topic: Mortality and burden of disease

Rationale: Measuring how many people die each year and why they died is one of the most important means – along with gauging how diseases and injuries are affecting people – for assessing the effectiveness of a country’s health system. Statistics of causes of death and disability help inform public health policy and planning.

Definitions:

Falls death rate: Number of deaths due to falls (unintentional injury) in a year, divided by the population and multiplied by 100 000.

DALY rate: Number of DALYs due to falls (unintentional injury) in a year, divided by the population and multiplied by 100 000.

YLD rate: Number of YLD due to falls (unintentional injury) in a year, divided by the population and multiplied by 100 000.

YLL rate: Number of YLL due to falls (unintentional injury) in a year, divided by the population and multiplied by 100 000.

Disaggregation: Age, Sex, Country, and Year.

The categories "All-ages, and Age-standardized included in the dimension Age, have the following meaning:

  • All-ages indicate that the death rate was computed by the aggregation of deaths from every age group, and the rate is crude (without removing the effect of age distribution across population groups or geographies).
  • Age-standardized indicates that the death rate refers to all ages but it has been age-standardized by the direct method using the WHO world standard population.

Method of estimation: Mortality and burden of disease measures by cause, age, sex, and location (countries, the region of the Americas, and subregions) were computed based on estimates of the absolute number of deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) due to premature mortality from the World Health Organization (WHO) Global Health Estimates 2019 (GHE). These data represent the best and most updated estimates of the WHO which have been computed using standard categories, definitions, and methods to ensure cross-country comparability, and may not be the same as official national estimates. 

Methodological details:

Data sources and methods for estimating causes of deaths and burden of diseases are described in the following documents

Method of estimation of the regional and subregional aggregates: Calculated by aggregating the country values (both numerator and the population) using population estimates from the World Population Prospects 2019, produced by the UN Population Division, as denominators.

Preferred data sources: Civil Registration and Vital Statistics (CRVS) systems with complete coverage and medical certification of cause of death.

  1. WHO. WHO methods and data sources for country-level causes of death 2000-2019. Geneva: World Health Organization; 2020. Available online (accessed 1 February 2021).
  2. WHO. WHO methods and data sources for global burden of disease estimates, 2000-2019. Geneva: World Health Organization, 2020. Available online (accessed 1 February 2021).
  3. PAHO. Methodological Notes, NMH Data Portal. Pan American Health Organization. 2021.
  4. WHO. Step Safely: Strategies for preventing and managing falls across the life-course. World Health Organization, 2021. Available online (accessed Oct 4, 201)

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