A much larger number of pedestrians are seriously injured in outdoor falls than in motor vehicle accidents, according to new Columbia University research.
The probability of a pedestrian suffering a severe injury is higher in a motor vehicle collision than in a fall, the research noted. However, the number of pedestrian-fall patients with a serious injury was twice as high as the number seriously hurt in motor vehicle accidents, the researchers said.
The study results justify an increased focus on outdoor-fall prevention, said Andrew Rundle, professor of epidemiology at the Columbia Mailman School, in a press release. “With the vast majority of injury occurring in urban spaces,” he said, “this suggests that urban design, policy, and built environment interventions are important tools for reducing pedestrian fall-related morbidity and are much needed compared to what currently exists in the U.S.”
Pedestrians Age 50 and Older
Among pedestrians age 50 or older, the number of pedestrians whose condition was coded as emergent or critical was 3.9 times as high for injurious falls as compared with pedestrians in motor vehicle collisions, the researchers found.
“The overall number of older pedestrians who fell and required EMS responses is alarming, especially the proportion determined to have critical and life-threatening injuries on the scene by EMS,” said the study’s co-author Alexander Lo, MD, in the release. Lo is an associate professor of emergency medicine at the Feinberg School of Medicine, Northwestern University.
With populations aging, creating urban environments that support the health and engagement of older persons is important, researchers said.
Lo added more study and new approaches are required. “Future studies should examine the health outcomes of these patients, including the extent of their injuries, rate of hospital admissions from the [emergency department], and the expected healthcare needs. Without this information, we are at a loss to clarify the public health, clinical, and social impacts of pedestrian falls in these environments.”
The Columbia University Mailman School of Public Health used 2019 emergency medical services (EMS) data for the study. Among the EMS encounters, 118,520 pedestrian falls and 33,915 pedestrian-motor vehicle collisions were identified within the dataset. The study was published in the Journal of Urban Health.
Previously, pedestrian injuries from falls were an understudied cause of morbidity, Columbia said. Urban policymakers have not focused much on interventions to prevent injurious pedestrian falls that occur on streets and sidewalks, it added. Most fall-prevention guidelines focus on in-home falls only.
“We argue that this likely arises from differences in who is responsible for, and who pays for, sidewalk (property owners) and road (local government) maintenance,” Rundle said. ”We also note a lack of robust surveillance systems for monitoring pedestrian falls occurring on sidewalks. And without such systems, it is difficult to understand the burden of falls and motivate the development of prevention programs or prioritize interventions programs to high-risk areas.”