Landscape of Falls in British Columbia, Canada

Introduction

In British Columbia (BC), Canada, falls are the leading contributor to injury-related direct health care costs, and the leading cause of injury-related hospitalization for all ages and deaths among adults ≥70 years-of-age. This burden is expected to increase as the population continues to grow and age. The purpose of this study is to investigate five-year trends and patterns of fall-related injuries in BC to inform injury prevention policies and practices.

Methods

Using ICD-10 codes W00-W19, fall-related deaths were obtained from BC Vital Statistics and hospitalizations from the Ministry of Health for 2018-2022. BC Children’s Hospital (BCCH) emergency department visits from 2017-2021 were obtained from the Canadian Hospitals Injury Reporting and Prevention Program. Trends and patterns were described by demographics, intent, type of fall, injury type, activity when injured, and place of occurrence.

Results

There were 2,916 fall-related deaths from 2018-2022, with rates increasing by 3% from 2018-2019. Highest rates were among males (11.83/100,000) and adults ≥85 year-of-age (266.56/100,000). There were 97,398 hospitalizations from 2018-2022, with rates increasing by 1% during this period. Highest rates were among females (441.07/100,000) and adults ≥85 years-of-age (5,399.32/100,000). Over 95% of deaths and hospitalizations were from unintentional falls, mostly at home. There were 24,838 BCCH emergency visits with 40% being sport-related, and falls accounting for 27% of concussions. Highest proportions were among males (56%) and children 5-9 years-of-age (29%). Playground equipment was involved in 30% of cases among children 5-9 years-of-age.

Conclusions

While recent fall-related deaths are currently underreported (2020-2022), hospitalizations continue to grow in burden, particularly among older women. Investments in province-wide, accessible healthy aging and fall prevention programming are warranted. Sports continue to be the leading cause of falls-related injury among children and youth seen in the BCCH emergency department, with concussions being a common injury.