Fall ll Prevention and the Socia ial Determinants of f Health Across the Lif ife Span November 12, 2019 12:00 PM EST Sandra Newton and Jennifer Russell T HIS WEBINAR IS BEING RECORDED . S TAY IN THE L OOP ! T HE SLIDE DECK AND RECORDING WILL BE WWW . FALLSLOOP . COM EMAILED AFTER THE WEBINAR . WWW . JR . FALLSLOOP . COM
Fall ll Prevention and the Socia ial Determinants of f Health Across the Lif ife Span November 12, 2019 12:00 PM EST Sandra Newton and Jennifer Russell T HIS WEBINAR IS BEING RECORDED . S TAY IN THE L OOP ! T HE SLIDE DECK AND RECORDING WILL BE WWW . FALLSLOOP . COM EMAILED AFTER THE WEBINAR . WWW . JR . FALLSLOOP . COM
Fall Prevention and the Social Determinants of Health Across the Life Span Sandra Newton, Child Safety Link Jennifer Russell, Atlantic Collaborative on Injury Prevention
Welcome & Introductions Jennifer Russell, Executive Director Atlantic Collaborative on Injury Prevention (ACIP) www.acip.ca Sandra Newton, Manager Child Safety Link (CSL) – IWK Health Centre https://childsafetylink.ca
Questions 1. What province/territory do you serve? 2. What sector do you work in? 3. Who is your primary target audience?
Outline • Purpose • Background and Framing Context • ACIP efforts • CSL efforts • Injury prevention spectrum • Linking Fall Prevention and the SDOH • The “so - what?” • Conclusion and Next Steps • Questions?
Purpose To help participants: • Learn about the links between fall-related injuries and social and economic conditions • Reflect on the social determinants of health links and what these mean in our work (using examples) • Demonstrate how we can move forward in addressing fall prevention across the lifespan using social policy examples
Social policy initiatives can reduce injuries by improving social and economic conditions and enabling individuals to increase control over and improve various aspects of their health.
Background & Framing Context
Fall-Related Injuries Falls rank high in injury-related deaths, hospitalizations, emergency room visits, permanent partial disabilities, and permanent total disabilities. The most frequent causes of falls are: • falls on stairs • falls on the same level, and • falls from furniture Other causes include: • falls from playgrounds; • falls from sport-related activities, such as falls from skates; and • falls from ladders/scaffolding
Fall-Related Injuries Child & Youth 0-14 years old In Canada • Falls are the #1 cause of injury hospitalization in children 0-14 years old. • In 2010, over 7000 children and youth aged 0-14 years were admitted to a hospital and over 150,00 visited an emergency department as a result of a fall. • Falls in children ages 0-14 years cost an estimated $1.2 billion.
Fall-Related Injuries Seniors (65 + years old) In Canada • Between 20% - 30% of seniors in Canada experience at least one fall every year • Fall-related hospitalizations of those living at home and in residential care are more frequent among women than men. • Traumatic brain injury, including concussions, and related mortality are significantly higher in older women and men. • In 2015, more than 28,000 older adults died and 3 million more were treated in emergency departments for non-fatal fall injuries. • In 2015, total medical costs for falls reached $50 billion (US), making falls one of the costliest health conditions among people aged 65 years and older.
ACIP’s Efforts In 2011, ACIP produced a report titled The Social Determinants of Injury : • An overview of the social and economic factors that contribute to intentional and unintentional injuries; • Importance of primordial prevention; • Identified those at higher risk for injury • Recommendations for improving data collection and prevention activities in the context of social and economic disparities.
ACIP’s Efforts In 2019, ACIP produced a report titled Fall Prevention Among Seniors and the Social Determinants of Health: A Social Policy Lens: • Background information on fall-related injuries among seniors • The social determinants of health and the evidence linking the social determinants of health to seniors fall prevention • Activities that seek to address the social determinants of health in preventing seniors falls • Current fall prevention initiatives by Atlantic Province • Examples of social policies
CSL’s Efforts Educational Resources • Backgrounder document Preventing Young Children's Falls in the Home (2018) • Infographic on child & youth fall prevention (2018) • CSL Educational resources on home safety including falls prevention (E/F). • Videos on Fall prevention (2012) including “The Great Child Safety Challenge” for Family Resource Centres (2014) • TV Public Service Announcements on falls/playground falls Workshop • Children’s Falls Prevention - Reaching for new heights at 2018 ACIP conference (NL)
CSL’s Efforts Research (includes fall prevention) • Preventing Serious Injuries in Children and Youth in Atlantic Canada: A Guide for Decision Makers (E/F) • Atlantic Canada: Child & Youth Unintentional Injury Hospitalizations – 10 Years in Review (2004-2013) • Challenges for safety & injury prevention for families in low-rental housing (2012) Former initiatives • Home Safety Curriculum for Family Resource Centres (2009-2017) • Virtual Safety House (2004-2012)
Framing Encouraging stakeholders to think beyond individual interventions. Encouraging the use of multiple strategies in order to achieve the highest degree of effectiveness.
The Spectrum of Prevention Source: The Prevention Institute. (n.d.). The Spectrum of Prevention. Retrieved from http://preventioninstitute.org/component/jlibrary/article/id-105/127.html
Examples Influencing Policy and Legislation Adopting safe housing legislation Long-term care facility Changing Organizational Practices implementing a safety practice Fostering Coalitions and Networks The Loop Canadian Fall Prevention Educating Providers Curriculum Promoting Community Education Public awareness campaigns A program teaching individuals exercise Strengthening Individual Knowledge and Skills movements to increase balance
Linking Fall Prevention and the Social Determinants of Health
Social Determinants of Health and Injury Injury does not affect all people equally. The conditions in which we live, work, and play = social determinants of health
Social Determinants of Health • Income and socio-economic • Social supports and coping status skills • Education and literacy • Access to health services • Employment and working • Healthy behaviours conditions • Biology and genetic • Early childhood endowment development • Gender • Physical environments • Culture
SDOH and Fall Prevention SDOH – INCOME WORKING LIVING PLAY CONDITIONS CONDITIONS ENVIRONMENT NEGATIVE EXPOSURES INCREASED RISK FOR INJURIES
How can we prevent fall-related injuries in the context of the social determinants of health? The “so - what”
What Can We Do? Social Policy = Injury Prevention Policy By improving daily living conditions, we can reduce rates of injury.
Social Policy • A range of benefits, programs, and supports that protect citizens through various life changes that can affect their health. • Function as a social safety net to ensure that people are not negatively impacted by these life changes whether they are positive or negative changes. • Considers the different roles of society, governments, communities, individuals, and other agencies in providing supports and services across the life span.
Social Policy Examples include (but not limited to): • Family allowances • Childcare • Employment insurance • Health and social services • Social assistance • Disability benefits • Home care • Retirement pensions
Social Policy SOCIAL POLICIES SOCIAL ASSISTANCE TAX CREDITS VULNERABLE POPULATIONS DECREASED INJURIES IMPROVED HEALTH
Implications for Injury Prevention Adequate investment into social policies would reduce injuries and other health issues in Canada.
Social Policy Examples in Atlantic Canada to Support Fall Prevention Efforts
Child & Youth Social Policy and Fall Prevention Social Policy Partner/Sector Links to SDOH & Fall Prevention Example to support fall prevention efforts Provincial Child Dept. of Community Financial Assistance to lower Benefit Services (NS) income families with children (can be used towards safety Finance & Treasury equipment (e.g. baby gates) Board (NB) Dept. of Advanced Education, Skills & Labour (NL)
Child & Youth Social Policy and Fall Prevention Social Policy Partner/Sector Links to SDOH & Fall Prevention Example to support fall prevention efforts Enhanced Home Provides an opportunity to Visiting Programs identify hazards in the home and educate parents about Best Start (PEI) Health PEI: Public preventing falls. Health Nursing Healthy Beginnings (NS) Dept. of Health & Wellness
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