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Article
Fall Risk is Not Black and White
Journal of Health Disparities Research and Practice
  • Dan K. Kiely, Hebrew SeniorLife
  • Dae H. Kim, Beth Israel Deaconess Medical Center
  • Alden L. Gross, Hebrew SeniorLife
  • Daniel A. Habtemariam, Hebrew SeniorLife
  • Suzanne G. Leveille, University of Massachusetts, Boston
  • Wenjun Li, University of Massachusetts Medical School
  • Lewis A. Lipsitz, Beth Israel Deaconess Medical Center
Keywords
  • geriatrics, gerontology, race, falls, health disparities, risk groups, epidemiology
Abstract

Objective: To determine whether previously reported racial differences in fall rates between White and Black/African American is explained by differences in health status and neighborhood characteristics.

Design: Prospective cohort

Setting: Community

Participants: The study included 550 White and 116 Black older adults in the Greater Boston area (mean age: 78 years; 36% men) who were English-speaking, able to walk across a room, and without severe cognitive impairment.

Measurements: Falls were prospectively reported using monthly fall calendars. The location of each fall and fall-related injuries were asked during telephone interviews. At baseline, we assessed risk factors for falls, including sociodemographic characteristics, physiologic risk factors, physical activity, and community-level characteristics.

Results: Over the mean follow-up of 1,048 days, 1,539 falls occurred (incidence: 806/1,000 person-years). Whites were more likely than Blacks to experience any falls (867 versus 504 falls per 1,000 person-years; RR [95% CI]: 1.77 [1.33, 2.36]), outdoor falls (418 versus 178 falls per 1,000 person-years; 1.78 [1.08, 2.92]), indoor falls (434 versus 320 falls per 1,000 person-years; 1.44 [1.02, 2.05]), and injurious falls (367 versus 205 falls per 1,000 person-years; 1.79 [1.30, 2.46]). With exception of injurious falls, higher fall rates in Whites than Blacks were substantially attenuated with adjustment for risk factors and community-level characteristics: any fall (1.24 [0.81, 1.89]), outdoor fall (1.57 [0.86, 2.88]), indoor fall (1.08 [0.64, 1.81]), and injurious fall (1.77 [1.14, 2.74]).

Conclusion: Our findings suggest that the racial differences in fall rates may be largely due to confounding by individual-level and community-level characteristics.

Citation Information
Dan K. Kiely, Dae H. Kim, Alden L. Gross, Daniel A. Habtemariam, et al.. "Fall Risk is Not Black and White"
Available at: http://works.bepress.com/suzanne_leveille/11/