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Obtaining Local Falls Data and Compiling Fall Hot Spot Data

(Prepared by the Los Angeles County Department of Public Health, Injury & Violence Prevention Program)

Compiling fall hot spot data by zip code will provide your jurisdiction with guidance on where older adults are most impacted by fall hospitalizations and deaths. While it is estimated that 1 in 3 adults age 65 and older fall each year, it is difficult to capture this data since many of these falls go unreported. Fall hospitalization and death data can illustrate the impact of more serious falls on your jurisdiction. While there are limitations to the fall data that are available, mapping fall hot spots can provide direction for targeting your resources and help assess your impact on fall reduction. Here is some guidance on what you need to compile fall hot spot data for your jurisdiction.

  • Identify your jurisdiction and the zip codes within your jurisdiction. Request data for all zip codes within that jurisdiction.
  • Request the total number of fall deaths and non-fatal fall hospitalizations for the most recent 5 years of data available. The number of falls per zip code, particularly fall deaths, will be relatively small. Additionally, a total count will enable you to show average rates to get a consistent picture of the impact of falls which may fluctuate year to year.
  • Fall rates are highest among older adults age 65+.  Request data for this age group if you are targeting fall prevention to older adults.
  • Obtain the most recent population data for each zip code. Your local health department should be able to provide this, or it can be obtained from the U.S. Census (see below).
  • Calculate Annual Rates per 100,000 population for each zip code. If 5 years of data were obtained, divide the total number of deaths/hospitalizations by 5 to get the average annual number before calculating rates.  Some health departments may have the capability to calculate rates, if it is requested.
  • Rank zip codes by highest rate of non-fatal fall hospitalizations and fall deaths to help target interventions to these areas.
  • Map data and identify communities where highest rates of non-fatal fall hospitalizations and fall deaths cluster, to help target interventions to these areas.
  • Data limitations
    • There is a 1-2 year lag with hospitalization and death data. For example in September 2012, Los Angeles County has access to 2011 hospitalization data and 2009 death data.
    • The number of fall deaths and hospitalizations is quite small for some zip codes, and the resulting rates should be interpreted with caution.  In addition, reporting restrictions that are in place to maintain confidentiality prohibit the disclosure of very small numbers of deaths/hospitalizations, so numbers may not be available for all zip codes.
    • Hospitalization and death data are provided at the zip code level, while population data are available by census tract, which are grouped into zip code tabulation areas (ZCTAs).  ZCTAs do not correspond exactly to zip codes, so rates calculated using these measures are an approximation.

Data & Mapping Resources

  • Hospitalization and mortality data: Contact your local health department to obtain hospitalization and mortality data. The role of health departments includes providing data to community members and organizations, however, capacity to provide data may differ by agency. The National Association of County and City Health Officials has compiled a directory of local health departments that is searchable by state or zip code: http://www.naccho.org/about/lhd/
  • Population data: Local health departments may be able to provide population data and calculate rates for requesters.  If that is not possible, population data can be downloaded from the Census website using their American Factfinder data query system. Through this source you can access population data from the decennial census and from the annual American Community Survey.  Data is available for different geographies; however, data is grouped into zip code tabulation areas (ZCTAs, see data limitations, above) not zip codes.  Data can also be downloaded for different demographic groups:  http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml
  • Your local health department may have the ability to map fall rates by zip code. If not, here is a free online mapping tool that will enable you to map data: http://www.esri.com/software/arcgis/explorer/