The geographic environment and the frequency of falling: a study of mortality outcomes in elderly people in China

Submitted: 26 December 2022
Accepted: 28 April 2023
Published: 25 May 2023
Abstract Views: 489
PDF: 322
HTML: 3
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Falling has become the first and second cause of death due to injury among urban and rural residents in China. This mortality is considerably higher in the southern part of the country than in the North. We collected the rate of mortality due to falling for 2013 and 2017 by province, age structure and population density, taking topography, precipitation and temperature into account. 2013 was used as the first year of the study since this year marks the expansion of the mortality surveillance system from 161 counties to 605 counties making available data more representative. A geographically weighted regression was used to evaluate the relationship between mortality and the geographic risk factors. High levels of precipitation, steep topography and uneven land surfaces as well as a higher quantile of the population aged above 80 years in southern China are believed to have led to the significantly higher number of falling compared with that in the North. Indeed, when evaluated by geographically weighted regression, the factors mentioned found a difference between the South and the North with regard to falling of 81% and 76% for the years 2013 and 2017, respectively. Interaction effects were observed between geographic risk factors and falling that, apart from the age factor, could be explained by topographic and climatic differences. The roads in the South are more difficult to negotiate on foot, particularly when it rains, which increases the probability of falling. In summary, the higher mortality due to falling in southern China emphasizes the need to apply more adaptive and effective measures in rainy and mountainous region to reduce this kind of risk.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Beard J, Officer A, Cassels A, 2016. The world report on ageing and health. Gerontologist S2:163-166. DOI: https://doi.org/10.1093/geront/gnw037
Bergen G, Stevens M, Burns E, 2016. Falls and fall injuries among adults aged ≥65 years-United States, 2014. Morb Mortal Wkly Rep 37:993-998. DOI: https://doi.org/10.15585/mmwr.mm6537a2
Chaccour K, Darazi R, Hassani A, Andres E, 2017. From fall detection to fall prevention: a generic classification of fall-related systems. IEEE Sens J 3:812-822. DOI: https://doi.org/10.1109/JSEN.2016.2628099
Cheng P, Wang L, Ning P, Yin P, Schwebel D, Liu J, Qi J, Hu G, Zhou M, 2019. Unintentional falls mortality in China, 2006-2016. J Glob Health 1:010603. DOI: https://doi.org/10.7189/jogh.09.010603
Chippendale T, Boltz M, 2015.The neighborhood environment: perceived fall risk, resources, and strategies for fall prevention. Gerontologist 4:575-583. DOI: https://doi.org/10.1093/geront/gnu019
Connell B, Wolf S, 1997. Environmental and behavioral circumstances associated with falls at home among healthy elderly individuals. Arch Phys Med Rehabil 78:179-186. DOI: https://doi.org/10.1016/S0003-9993(97)90261-6
Gillespie L, Robertson M, Gillespie W, Lamb S, Gates S, Cumming R, Rowe B, 2012. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 9:CD007146. DOI: https://doi.org/10.1002/14651858.CD007146.pub3
Hong W, Peng O, 2017. Fall prevalence, time trend and its related risk factors among elderly people in China. Arch Gerontol Geriatr 73:294-299. DOI: https://doi.org/10.1016/j.archger.2017.08.009
Jeon M, Gu M, Yim J, 2017.Comparison of walking, muscle strength, balance, and fear of falling between repeated fall group, one-time fall group, and non fall group of the elderly receiving home care service. Asian Nurs Res 11:290-296. DOI: https://doi.org/10.1016/j.anr.2017.11.003
Liu S, Wu X, Lopez A, Wang L, Cai Y, Page A, Yin P, Liu Y, Li Y, Liu J, You J, Zhou M, 2016.An integrated national mortality surveillance system for death registration and mortality surveillance, China. Bull World Health Organ 1:46-57. DOI: https://doi.org/10.2471/BLT.15.153148
National Health Commission of People’s Republic of China, 2021. Annual book on health statistics of China. Peking union medical college press. Beijing, China.
Park H, Chang R, Park K, 2008. Comparative study on fall related characteristics between single and recurrent falls in community-dwelling older women. Korean J Adult Nurs 20:905-916.
Peng K, Tian M, Andersen M, Zhang J, Liu Y, Wang Q, Lindley R, Ivers R, 2019.Incidence, risk factors and economic burden of fall-related injuries in older Chinese people: a systematic review. Inj Prev 25:4-12. DOI: https://doi.org/10.1136/injuryprev-2018-042982
Rubenstein L, 2006. Review Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing S2:1137-1141. DOI: https://doi.org/10.1093/ageing/afl084
Rubenstein L, Josephson K, 2002. The epidemiology of falls and syncope. Clinics in geriatric medicine2:141-158. DOI: https://doi.org/10.1016/S0749-0690(02)00002-2
Spirduso W, Francis K, Eakin T, Stanford C, 2005. Quantification of manual force control and tremor. J Mot Behav 37:197-210. DOI: https://doi.org/10.3200/JMBR.37.3.197-210
Tineiti M, Baker D, McAvay G, Claus E, Garrett P, Gottschalk M, Koch M, Trainor K, Horwitz R, 1994. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med 13:881-827. DOI: https://doi.org/10.1056/NEJM199409293311301
WHO, 2002. The injury Chart Book: a graphical overview of the global burden of injuries. WHO, Geneva, Switzerland 2022.
WHO, 2018. Falls. Available at: http://www.who.int/ mediacentre/factsheets/fs344/en/
Ye P, Er Y, Wang H, Fang L, Li B, Ivers R, Keay L, Duan L, Tian M, 2021. Burden of falls among people aged 60 years and older in mainland China, 1990–2019: findings from the Global Burden of Disease Study 2019. Lancet Publ Health 12:907-918. DOI: https://doi.org/10.1016/S2468-2667(21)00231-0
Yoo I, 2011.Analysis of multi-variate recurrent fall risk factors in elderly people using Residential Assessment Instrument-Home Care: comparisons between single and recurrent fallers. J Korean Acad Nurs 41:119-128. DOI: https://doi.org/10.4040/jkan.2011.41.1.119
Yoo J, Kim C, Yim J, Jeon M, 2019. Risk factors of repeated falls in the community dwelling old people. J Exerc Rehabil 2:275-281. DOI: https://doi.org/10.12965/jer.1938086.043
Zhang L, Ding Z, Qiu L, Li A, 2019. Falls and risk factors of falls for urban and rural community-dwelling older adults in China. BMC Geriatrics 19:379. DOI: https://doi.org/10.1186/s12877-019-1391-9
Zhao M, Wang H, He Y, Xu J, Yu M, 2016. Analysis of epidemic features and risk factors of the elderly falls among nursing home residents. Chin J Emerg Med 5: 654-658. (In Chinese with English abstract)
Zhou M, Wang H, Zhu J, Chen W, Wang L, Liu S, Li Y, Wang L, Liu Y, Yin P, Liu J, Yu S, Tan F, Barber RM, Coates MM, Dicker D, Fraser M, González-Medina D, Hamavid H, Hao Y, Hu G, Jiang G, Kan H, Lopez AD, Phillips MR, She J, Vos T, Wan X, Xu G, Yan LL, Yu C, Zhao Y, Zheng Y, Zou X, Naghavi M, Wang Y, Murray CJ, Yang G, Liang X, 2016. Cause-specific mortality for 240 causes in China during 1990–2013: a systematic sub-national analysis for the Global Burden of Disease Study 2013. Lancet 387:251-272. DOI: https://doi.org/10.1016/S0140-6736(15)00551-6

How to Cite

Huang, Y., Li, C., Lu, X., & Wang, Y. (2023). The geographic environment and the frequency of falling: a study of mortality outcomes in elderly people in China. Geospatial Health, 18(1). https://doi.org/10.4081/gh.2023.1180