On January 1 1999 the USA switched from ICD-9 to ICD-10 for reporting mortality. (ICD-10 was not used for non-fatal clinical coding until 2015.) And as with all new things, morticians likely stuck with the more generic codes from ICD-9 and gradually started using some of the more specific iCD-10 codes over time. ICD-10 has 55,000 different codes compared to 17,000 codes available in ICD-9.
Could the gradual adoption of a more granular coding system in 1999 explain the increase in reported deaths due to falling that starts in 2000?
I guess the hypothesis makes sense. They say it's probably Drugs, Alcohol, Obesity and Fourth, some of the increase may be due to changes in reporting. As people have become more aware of the danger of falls, falls that used to not be recorded as a cause of death may increasingly be reported as a cause.
I'm curious how many deadly falls are the result of an ilness. Would having an heart attack in an unlucky moment skew the statistics? I guess they normally would not research the cause of death deeper if there is an obvious reason.
A good friend recently lost her dad to a fall in his back yard. Technically it was a second or third stroke in the past few years, but this time he also fell backwards onto a cement stepping stone in his backyard.
So you're correct that these things can often be related.
Another friend has never had a fainting spell in his life. But three years ago, fainted luckily forward I guess, and knocked out a tooth.
I'd add overwhelmingly increasing stupidity by enforced safety, preventing people from learning from their (small) mistakes, leading to big ones. Just recently I was talking to a friend about how everything agile is being exterminated in favor of safety, e.g. police chasing two lonely cars slowly drifting on a frozen public mountain road during the night with no other cars/people in sight due to "endangering public". How else should people learn how to handle critical situations than being exposed to them in a low-risk controlled manner?
Aside from alcohol and obesity, I don't see:
1. Cancer survivability. If people aren't dying from cancer they will be more likely to die from a fall in a weakened state.
2. Two level homes are a higher percentage of new construction and people are more able to afford it when they're older.
Edit: okay they did mention fewer deaths from other causes such as cancer and heart disease.
The stairs are probably your least likely place to fall. You have a railing. Getting out of the shower or slipping in the kitchen and catching the counter on the way down however…
There is an unmet need for mandatory (stylish) shower bars. Age doesn't matter; everybody could benefit from a solid handhold in that critical in/out transition.
Like anything it depends. I'm terrified at the idea that my mother in law or my mom would slip on my stairs at home. We used to have carpeted basement stairs and I slipped on them several times. They're wood with silicone traction pads now and far safer.
The article did address differences in the rates of 'same level falls' vs. stairs, etc. So they accounted for that too.
We just finally got my 85-yr-old mother to move out of her house into a nice apartment near us with elevator access. She has already had some bad falls. Now we just have to worry about her driving. She shouldn't need to drive as much in her new place, but she probably will anyway.
> Second, some of the increased deaths may be due to rising alcohol consumption. According to data from the National Survey of Drug Use and Health (NSDUH), the percentage of people aged 65 or older who consume alcohol each month increased by 16% between 2002 and 2019. From 2002–2003 to 2021–2023, the share of this group who reported binge drinking in the past 30 days rose from 7.3% to 11.4%
I've been hearing nothing but the complete opposite, that people are drinking less than ever
> Americans' drinking habits are shifting amid the medical world’s reappraisal of alcohol’s health effects. After decades of relative steadiness in the proportion of U.S. adults who drink, Gallup has documented three consecutive years of decline in the U.S. drinking rate as research supporting the “no amount of alcohol is safe” message mounts. Compounding the challenge for companies that sell alcohol, drinkers now appear to be dialing back how much they drink, as well.
I suppose so. But the leading line before their 5 points made it sound like they were trying to explain why the fall deaths were increasing regardless of age.
> Why have deaths from falls, on an age-adjusted basis, risen? There are at least five possible reasons.
It's a tricky term, but the definition given towards the top where "age-adjusted" is clickable helps clarify. It's introduced in "But an aging population only partially explains the rise in these deaths. Deaths by falls have risen 2.4-fold on an age-<adjusted basis>. " The <clickable> part in brackets (easy to miss) expands to:
> Age-adjusted data helps to compare health data over time or between groups more fairly by accounting for the age differences in populations. For example, suppose Population A has a higher average age than Population B. In that case, age-adjusting ensures that Population A's naturally higher death rate due to age doesn't skew comparisons of overall health between the two. This measurement makes death statistic comparisons more accurate than crude death rates.
An "age group" might be "45-54" or "85+" but a "population" would be "all age groups in 2000" or "all age groups in 2023". Age-adjusted here means the differences in the number of people in each population (2000 vs 2023) are normalized to each so we can compare the absolute numbers from each age group directly, not the other way around.
There is some immediate follow-up text which helps clarify they do not mean to normalize the age groups themselves together within a single population for comparison:
> While they [population age-adjusted fall deaths] have fallen among younger people and only risen slightly among the middle aged, they have risen substantially within every age bracket of the elderly.
This all gave me flashbacks to stats class, and I now need to go relax :).
Notice the age range is 65 or older. There is a large cohort of Boomers/GenX/Millenial drinkers who are aging up. The overall downtrend is that younger people are not starting to drink. But those who contributed to the initial rise are getting older.
I imagine that would be one positive effect of endless entertainment being ubiquitous- since people can zone out in front of a screen with any entertainment medium of their choosing, they are less likely to opt for alcohol.
Though interestingly, drunk driving fatalities are rising despite lowering alcohol consumption[1], even discounting the pandemic contriting large jumps up. So of the people that do drink, they're more likely to drive after doing so? It seems like an interesting topic to study.
Anecdotally the drinking culture that existed for me in my youth has completely disappeared. House parties, a staple of my college years, are nonexistent. Talking to recent grads from the same school, their social life looks very different.
I think this is connected to social media but in a different way. Young people are very aware that any deviant behavior will be recorded and posted. Also they are deathly afraid of being "cringe."
Talking to some recent grads (last few years) last summer, parties were pretty much confined to frat parties. The school had a very vibrant house party scene circa 2010, but it sounded dead even pre-Covid. The people I talked to were at a music festival, so high cross over with those who would have attended the parties, not those who spent college locked in a dorm. I was very shocked to hear the difference in experience with within a decade.
I'll throw this out. Due to inflation and cheaper goods (Baumol effect) more people are engaged in activities which can lead to accidental falls - DIY projects like cleaning gutters.
I would assume it is because of the extra distractions now. Everything becoming "smarter" and more addictive. How many were looking at their phones, hurrying back to catch the increasingly manipulative "news", or frustrated because their voice assistant didn't understand them?
Since 2000 all of these things, and the amount of tech per household in general, have gone up quite a bit. I'm surprised it wasn't listed as a hypothesis worth looking at.
The increase was greatest in the groups least likely to engage in that behavior.
The hypotheses in the article are much stronger. To me, the increasing use of mind altering drugs in geriatric care is an obvious contributor... so much so that these drugs list that risk on the label.
Anecdotally, several of my extended family are now on SSRIs because it helps alleviates their pain from rheumatoid arthritis. My mom in particular often complains about fainting; if I was taking similar high dosages of painkillers, SSRIs, and other drugs targeting the nervous system I would faint too.
The hypotheses in the article are much stronger. To me, the increasing use of mind altering drugs in geriatric care is an obvious contributor... so much so that these drugs list that risk on the label.
I would hope the article is better than the gut feeling of some random programmer commenting on hn before his standup.
The increase was greatest in the groups least likely to engage in that behavior.
I must point out that the elders in my life are the most tech addicted people I know. They barely know how to use it, but they never put it down. Which means they are constantly struggling to get their fix. I saw this behavior 25 years ago doing tech support for a dial-up ISP, and it has become way more common since. To the point that the senior citizen posting nonsense on facebook, and forwarding email chains is a common trope.
Again, I'm sure the article is doing better research than my personal experience, I was just surprised it wasn't mentioned.
Elderly people scroll facebook while sitting down, not while walking around... especially if they are of the physical condition where a fall at grade would kill them.
My mother fell and broke her shoulder a few years ago because she heard a ding on her ipad and was rushing back to check it. In 1999, it would have only been the telephone giving her alerts.
Last millennium there were vanishingly few phones that elderly people just had in their pocket ready at a moments notice. Wouldn't it have previously been more likely that people had to run across the house for the phone before pocketable phones, texting, and voicemail?
This is my first guess too. There's some stat that says more people die from falling while they try to frame a selfie compared to dying because of shark attacks... (Ok death by shark is actually quite rare)
I wonder if it's about 1/3 as easy to find an under 35 year old handyman as it was in the year 2000.
Since 2020 the price of maintaining anything in your house has exploded, coupled with dwindling value of fixed incomes, which has got to be getting a lot more old people up on ladders.
I almost mentioned that too, but I thought I was going to expose myself for being bad at maintaining my house.
Going down the same line of thought, how many people are attempting DIY repairs that they never would have before because of youtube and other resources? I know that I have done way more work on my home than my parents or grandparents ever did.
I'm over 65 and I'm fabbing a ladder to permanently install on my high-aspect roof at the moment (out of iron. drilling, cutting, bending, welding, threading rods, oh my!). I'll get to install it myself, too. Every few years I get out a credit card and rent a 40' (overkill!) Z-lift for a week, it's much better than working on ladders for anything major, like repairing / replacing fascia or installing wire cloth over the gutters: America, gotta love it. And there's no OSHA inspector to worry about when you're the property owner as well as equipment operator.
I view it as exercise. If people don't need me to prep their data or fix their internet plumbing, I have other things to do (and it's possible someone will see the work and I get a side gig, it's happened before).
Ironically yesterday I was stapling wire cloth at the top of the stairs on the wooden deck because it gets slippery.
It is hard to find good handy help. They "repaired" a gutter by nailing it to the crown moulding, which is not structural (resulting in the failure of the fascia, but I digress); repaired copper supply lines with plastic; didn't tighten a slip ring on a sewer trap in the crawlspace. We just had a new roof put on, and overall they did a competent job but there is one leak, coming from a problem we explicitly paid them to solve, and getting that fixed is going real slow. The guy responsible for that aspect is obviously not a native english speaker; OTOH we prevailed on them to install some overhangs, and the carpenter worked with us and allowed us to paint the decking / sheathing / soffit which would be exposed before it was installed. During one of my burnouts I worked as an estimator for a high-end wood flooring company; literally over half of our competition was illegal, unlicensed, and sometimes part of an acknowledged criminal enterprise (not totally throwing shades at people who aren't from here, we had five crews and the Italian and the former Russian physicist (beautiful inlay work!) crew leads were class acts). But I digress.
I've done crazy shit my whole life, my dad died scuba diving at 52 (cause of death was inconclusive) but his brother lived into his 90s. A couple of years ago my father-in-law died after a fall; he was taking photographs in a park. Somehow when he fell he broke his neck; could have been a stroke, but he never really stabilized enough to find out, was dead within a week. He was in his 80s.
It is weird that the graphed increase grows steadily at presumably the same rate - there is no spike or bump or curve. I wonder if that indicates anything.
Disregarding the shape of the graph, I would have guessed at a change in reporting instead.
The steadily rising curve almost looks like something being gradually employed.
At some point, the curve ought to change direction, if not before, then after the last person has fallen over.
I can tell you from personal experience losing a lot of my mobility at a young-ish age, the bathroom is by far and away the most terrifying place for me, especially getting into and out of the shower. It was the first place I started installing safety mechanisms - wouldn't be surprised if bathroom falls are a significant percentage, and stairs.
I didn’t see this discussing whether falls have become more dangerous. How much of this is because the elderly fall more often and how much because, if they fall, they’re more likely to die?
If the latter, it seems the elderly have gotten worse at falling, possibly because they fall less at young age, and aren’t as good in breaking their fall as before.
And yes, it will be difficult to gather data on ”fell with little consequences”, but for the elderly, many falls will lead to doctor visits, so there likely is data on that.
The line between "falling" and "not falling" is extremely blurry for children- they will often do things like jump around, tuck and roll on the ground, hop like frogs and then scamper up the stairs on all fours and then flop down and roll around. Does that constitute a fall? Who knows. When i was young I remember reading on a form at a doctor's office "have you fallen in the last year?" And finding that an extremely humorous question. "Have you fallen in the last 5 minutes" would have been a more meaningful one but still very silly.
Even now at my age (40's) this fall I was crowd surfing at a car seat headrest concert in a black dress, and when I got to the front I was dropped in front of the stage, and then I stood up laughing and walked off to find my friends. Was that a fall? I don't know. Its just not really a question that makes sense when youre physically fit or young.
If you are sharing facts like "Wisconsin falls are more deadly than Alabama falls", then you need to address the more obvious hypotheses that are conjured in the readers head.
I found no mention of "ice" or "slippery", and instead the article blazed forward with its preferred explanation without providing evidence to dismiss the more obvious hypotheses.
>Another state-level predictor of accidental fall death rates is wintry weather: eight of the 10 states with the highest age-adjusted rates are notably snowy.
>Wisconsin, Maine, Vermont, Minnesota, Rhode Island, Iowa, New Hampshire, and South Dakota. The two states in the top 10 that are not notably snowy are Oklahoma and Oregon.
Presumably because the Wisconsin-vs-Alabama differences have not significantly changed in the last few decades? Wisconsin has been a lot snowier than Alabama for a long time.
What's possibly more relevant is that Wisconsin has unusually high rates of alcohol abuse. Their high rate of fall-related deaths may be better understood as a high rate of alcohol-related deaths which involve falls.
This might be evidence that the gravitational constant G is changing (increasing) over time! Could this be the explanation for dark matter and dark energy?
This would also explain why my bathroom scale has been showing larger and larger numbers to me! Genius. I'd say you're onto something, but I can't tell if you're also joking.
Occam's razor says it's less likely that the gravitational constant is increasing and more likely that the ability to withstand the pull of gravity decreases with age.
I read that fall injuries in the elderly are a significant contributor to both death and drops in quality of life.
When it comes to proprioception and balance one group of people over 60 seem to have equivalent balance to younger people and that is certain kinds of rollerbladers.
So as a person who was relatively active (40mi+ per week biking and other things) I started rollerblading and it's been unbelievable, I'm older and certain types of movements that take 8yr olds a couple weeks to learn took me nearly a year, it's absolutely amazing though, pain and soreness in parts of my leg and feet all related to stabilization, significantly strengthened stabilization muscles and improved reaction times at speed. I figure if I can rollerblade on one foot at 15 miles an hour, walking with both feet at 3 should be no problem.
I put rollerblading and bouldering as my top two 'puzzle' based activities.
Yoga is a great idea but many who find it boring are getting the same poses at 15mph and with more dynamic load and interruption (due to rocks and other high speed road defects.) There is quite a bit of overlap but unless you are doing acro yoga there is also quite a bit that doesn't overlap.
Which was specifically addressed early in the article.
Not only are there more falls among the elderly, there are more falls even fully accounting for changes in age composition of the population.
>>But an aging population only partially explains the rise in these deaths. Deaths by falls have risen 2.4-fold on an age-adjusted basis. While they have fallen among younger people and only risen slightly among the middle aged, they have risen substantially within every age bracket of the elderly.
As a side note, I've gotten my dad into dirtbiking for the first time at 65.
He has padded shorts, and padding pants, and a padded shirt. He then wears my track leathers, even though he's on dirt. He's fallen a few times and he agrees you feel like superman.
He's started joking that if he makes it to 75, he's going to start wearing the padded shorts and shirt as regular daily wear.
I have always thought once I get to a certain age I might just start wearing a helmet...everywhere when standing. It will look silly, but maybe it's not such a bad idea.
Padded shorts with hip protection arent really visible in clothes. Wearing a helmet would make you look pretty crazy hah.
But helmets are also designed to deal with impacts stronger than just falling over. For falls, people might do ok with just padded hats that were designed for just falls.
From sad experience with my own family - I'd also consider declining quality of treatment. Patients who fell may be neither cool nor lucrative for the medical-industrial complex. Also said complex protecting its own, by attributing some "oops, we goofed" deaths to falls.
> Third, it may be due to increased rates of obesity. A CDC study found that obesity increased the propensity for someone to fall in a laboratory setting. And obesity rates among people 60 and older rose from about 32.8% in 2001-2002 to 38.5% in recent years.
It's not just the chance of falling itself that warrants a look. More weight also means more energy dissipated.
On top of that, the problems with falls start to get really serious once fractures get into play [1].
What I can't find any data on is a change of floor material compositions. Anecdotally, I remember many of my older relatives having really soft carpets in their homes, while in more modern homes and even care institutions you will find hard material - hard carpet, wood, tiles or in institutions, straight concrete. All of these have the advantage that you can keep them clean and hygienic with far less effort - but damn, even as a younger person it hurts much more tripping over my cat when in areas with hard flooring. And they're slippery when wet!
For an older or obeser person, it sounds at least plausible that the flooring material contributes to more severe (and, consequentially, more fatal) fall events.
Looking at the article's graphs - both the deaths and the increase in deaths are very strongly skewed toward the highest age brackets. Deaths fell in the 34-and-under brackets.
Are 85+ folks falling more (or worse), because they're paying more attention to their phones than to their feet? Or maybe the fatal falls are caused by collisions with nose-in-phone kids?
Fall fatalities for people 25-34 are likely related to working at height or recreational climbing, during which the victim is less likely to be using electronic devices.
People fall because the surroundings are unfamiliar, their trust and assumptions about things around them, and about themselves, have gone wrong. Why does this discrepancy arise? For older people, the world around them and food they eat has changed too fast, to the extent of being an alien land. They walk on a surface, making assumptions based on what they were familiar with in the past. But the surface is no longer the same. They eat the changed food, assuming that it will keep them as strong as before. That turns out to be false as well. Most old people feel that they are living in a world that is completely unfamiliar and untrustworthy.
I think this can be seen here up north, where people fall through ice and drown every fall and (more commonly) spring. It's not a new thing – these people are almost always male, at least in their 50s, alone on the ice, and taking stupid unnecessary risks trying to reach their favorite ice fishing spot or whatever – but I can't help but think that increasingly these deaths are caused by assumptions that the ice is strong enough because it has "always been at this time of the year". Except that it isn't, not anymore. Or even if it is this year, the annual variance is much greater.
Ofcourse, it applies to younger people as well. I didn't exclude them.
Other than, if it sounds like "ai slop" to you, you probably did not expect a properly written statement from real people. It gotten to a point someone saying real world experience witnessed by me as "ai slop". This HN land became unfamiliar alien land to me now. Do I need to force myself to sound trivial, incorrect, slangish?
And the disconnection is .. ? Infact, forget it. Your comment proves that this is already at ridiculous level. The message I posted about alienation of old people with the changing world, close to my heart than anything else, as I went through painful experiences that lasted for decades.
And now treading the slippery slope of social forums of HN, where the floor suddenly slips and we fall into getting called as "ai-written". This world is done.
On January 1 1999 the USA switched from ICD-9 to ICD-10 for reporting mortality. (ICD-10 was not used for non-fatal clinical coding until 2015.) And as with all new things, morticians likely stuck with the more generic codes from ICD-9 and gradually started using some of the more specific iCD-10 codes over time. ICD-10 has 55,000 different codes compared to 17,000 codes available in ICD-9.
Could the gradual adoption of a more granular coding system in 1999 explain the increase in reported deaths due to falling that starts in 2000?
Great find!
I guess the hypothesis makes sense. They say it's probably Drugs, Alcohol, Obesity and Fourth, some of the increase may be due to changes in reporting. As people have become more aware of the danger of falls, falls that used to not be recorded as a cause of death may increasingly be reported as a cause.
Large changes almost always represent a change in reporting, don't they?
I'm curious how many deadly falls are the result of an ilness. Would having an heart attack in an unlucky moment skew the statistics? I guess they normally would not research the cause of death deeper if there is an obvious reason.
A good friend recently lost her dad to a fall in his back yard. Technically it was a second or third stroke in the past few years, but this time he also fell backwards onto a cement stepping stone in his backyard. So you're correct that these things can often be related. Another friend has never had a fainting spell in his life. But three years ago, fainted luckily forward I guess, and knocked out a tooth.
Man, I knew Trump was a big Putin fan but I didn't think the US would follow Russia that quickly.
(This is satire, for the humor-impaired).
[dead]
I'd add overwhelmingly increasing stupidity by enforced safety, preventing people from learning from their (small) mistakes, leading to big ones. Just recently I was talking to a friend about how everything agile is being exterminated in favor of safety, e.g. police chasing two lonely cars slowly drifting on a frozen public mountain road during the night with no other cars/people in sight due to "endangering public". How else should people learn how to handle critical situations than being exposed to them in a low-risk controlled manner?
Aside from alcohol and obesity, I don't see: 1. Cancer survivability. If people aren't dying from cancer they will be more likely to die from a fall in a weakened state. 2. Two level homes are a higher percentage of new construction and people are more able to afford it when they're older.
Edit: okay they did mention fewer deaths from other causes such as cancer and heart disease.
Fewer small (one-level) homes is an excellent point. Also a lot of old people used to live in trailer homes or mobile homes, which are also one-level.
The stairs are probably your least likely place to fall. You have a railing. Getting out of the shower or slipping in the kitchen and catching the counter on the way down however…
There is an unmet need for mandatory (stylish) shower bars. Age doesn't matter; everybody could benefit from a solid handhold in that critical in/out transition.
Like anything it depends. I'm terrified at the idea that my mother in law or my mom would slip on my stairs at home. We used to have carpeted basement stairs and I slipped on them several times. They're wood with silicone traction pads now and far safer.
I agree less likely, but I wonder if more likely to be fatal when they happen? Just a guess.
The article did address differences in the rates of 'same level falls' vs. stairs, etc. So they accounted for that too.
We just finally got my 85-yr-old mother to move out of her house into a nice apartment near us with elevator access. She has already had some bad falls. Now we just have to worry about her driving. She shouldn't need to drive as much in her new place, but she probably will anyway.
> Second, some of the increased deaths may be due to rising alcohol consumption. According to data from the National Survey of Drug Use and Health (NSDUH), the percentage of people aged 65 or older who consume alcohol each month increased by 16% between 2002 and 2019. From 2002–2003 to 2021–2023, the share of this group who reported binge drinking in the past 30 days rose from 7.3% to 11.4%
I've been hearing nothing but the complete opposite, that people are drinking less than ever
https://news.gallup.com/poll/693362/drinking-rate-new-low-al...
> Americans' drinking habits are shifting amid the medical world’s reappraisal of alcohol’s health effects. After decades of relative steadiness in the proportion of U.S. adults who drink, Gallup has documented three consecutive years of decline in the U.S. drinking rate as research supporting the “no amount of alcohol is safe” message mounts. Compounding the challenge for companies that sell alcohol, drinkers now appear to be dialing back how much they drink, as well.
How are they finding completely opposite trends?
Your quoted paragraphs are not discussing the same trend, your first paragraph is referring to drinking habits in those 65 or older.
The second paragraph is discussing drinking habits for all US adults.
I suppose so. But the leading line before their 5 points made it sound like they were trying to explain why the fall deaths were increasing regardless of age.
> Why have deaths from falls, on an age-adjusted basis, risen? There are at least five possible reasons.
It's a tricky term, but the definition given towards the top where "age-adjusted" is clickable helps clarify. It's introduced in "But an aging population only partially explains the rise in these deaths. Deaths by falls have risen 2.4-fold on an age-<adjusted basis>. " The <clickable> part in brackets (easy to miss) expands to:
> Age-adjusted data helps to compare health data over time or between groups more fairly by accounting for the age differences in populations. For example, suppose Population A has a higher average age than Population B. In that case, age-adjusting ensures that Population A's naturally higher death rate due to age doesn't skew comparisons of overall health between the two. This measurement makes death statistic comparisons more accurate than crude death rates.
An "age group" might be "45-54" or "85+" but a "population" would be "all age groups in 2000" or "all age groups in 2023". Age-adjusted here means the differences in the number of people in each population (2000 vs 2023) are normalized to each so we can compare the absolute numbers from each age group directly, not the other way around.
There is some immediate follow-up text which helps clarify they do not mean to normalize the age groups themselves together within a single population for comparison:
> While they [population age-adjusted fall deaths] have fallen among younger people and only risen slightly among the middle aged, they have risen substantially within every age bracket of the elderly.
This all gave me flashbacks to stats class, and I now need to go relax :).
The fact that overall drinking is decreasing is 100% compatible with the drinking rate increasing for some specific age cohort.
https://en.wikipedia.org/wiki/Simpson%27s_paradox
Notice the age range is 65 or older. There is a large cohort of Boomers/GenX/Millenial drinkers who are aging up. The overall downtrend is that younger people are not starting to drink. But those who contributed to the initial rise are getting older.
I imagine that would be one positive effect of endless entertainment being ubiquitous- since people can zone out in front of a screen with any entertainment medium of their choosing, they are less likely to opt for alcohol.
Though interestingly, drunk driving fatalities are rising despite lowering alcohol consumption[1], even discounting the pandemic contriting large jumps up. So of the people that do drink, they're more likely to drive after doing so? It seems like an interesting topic to study.
[1] https://www.safehome.org/resources/dui-statistics/
Anecdotally the drinking culture that existed for me in my youth has completely disappeared. House parties, a staple of my college years, are nonexistent. Talking to recent grads from the same school, their social life looks very different.
I think this is connected to social media but in a different way. Young people are very aware that any deviant behavior will be recorded and posted. Also they are deathly afraid of being "cringe."
Is this really true? College kids are not making drinking parties anymore?? I can’t even fathom that.
Talking to some recent grads (last few years) last summer, parties were pretty much confined to frat parties. The school had a very vibrant house party scene circa 2010, but it sounded dead even pre-Covid. The people I talked to were at a music festival, so high cross over with those who would have attended the parties, not those who spent college locked in a dorm. I was very shocked to hear the difference in experience with within a decade.
I'll throw this out. Due to inflation and cheaper goods (Baumol effect) more people are engaged in activities which can lead to accidental falls - DIY projects like cleaning gutters.
Or due to economic circumstance people are DIYing things deeper into old age.
I would assume it is because of the extra distractions now. Everything becoming "smarter" and more addictive. How many were looking at their phones, hurrying back to catch the increasingly manipulative "news", or frustrated because their voice assistant didn't understand them?
Since 2000 all of these things, and the amount of tech per household in general, have gone up quite a bit. I'm surprised it wasn't listed as a hypothesis worth looking at.
The increase was greatest in the groups least likely to engage in that behavior.
The hypotheses in the article are much stronger. To me, the increasing use of mind altering drugs in geriatric care is an obvious contributor... so much so that these drugs list that risk on the label.
Anecdotally, several of my extended family are now on SSRIs because it helps alleviates their pain from rheumatoid arthritis. My mom in particular often complains about fainting; if I was taking similar high dosages of painkillers, SSRIs, and other drugs targeting the nervous system I would faint too.
> the groups least likely to engage in that behavior.
Actually, the Elderly are even more hooked into technology and its distractions.
The Phone-Based Retirement Is Here - https://archive.ph/eieyI
The hypotheses in the article are much stronger. To me, the increasing use of mind altering drugs in geriatric care is an obvious contributor... so much so that these drugs list that risk on the label.
I would hope the article is better than the gut feeling of some random programmer commenting on hn before his standup.
The increase was greatest in the groups least likely to engage in that behavior.
I must point out that the elders in my life are the most tech addicted people I know. They barely know how to use it, but they never put it down. Which means they are constantly struggling to get their fix. I saw this behavior 25 years ago doing tech support for a dial-up ISP, and it has become way more common since. To the point that the senior citizen posting nonsense on facebook, and forwarding email chains is a common trope.
Again, I'm sure the article is doing better research than my personal experience, I was just surprised it wasn't mentioned.
Elderly people scroll facebook while sitting down, not while walking around... especially if they are of the physical condition where a fall at grade would kill them.
My mother fell and broke her shoulder a few years ago because she heard a ding on her ipad and was rushing back to check it. In 1999, it would have only been the telephone giving her alerts.
Last millennium there were vanishingly few phones that elderly people just had in their pocket ready at a moments notice. Wouldn't it have previously been more likely that people had to run across the house for the phone before pocketable phones, texting, and voicemail?
This is my first guess too. There's some stat that says more people die from falling while they try to frame a selfie compared to dying because of shark attacks... (Ok death by shark is actually quite rare)
The death rates increased 200% for 85+ year olds but deceased for people under 35.
I wonder if it's about 1/3 as easy to find an under 35 year old handyman as it was in the year 2000.
Since 2020 the price of maintaining anything in your house has exploded, coupled with dwindling value of fixed incomes, which has got to be getting a lot more old people up on ladders.
I almost mentioned that too, but I thought I was going to expose myself for being bad at maintaining my house.
Going down the same line of thought, how many people are attempting DIY repairs that they never would have before because of youtube and other resources? I know that I have done way more work on my home than my parents or grandparents ever did.
I'm over 65 and I'm fabbing a ladder to permanently install on my high-aspect roof at the moment (out of iron. drilling, cutting, bending, welding, threading rods, oh my!). I'll get to install it myself, too. Every few years I get out a credit card and rent a 40' (overkill!) Z-lift for a week, it's much better than working on ladders for anything major, like repairing / replacing fascia or installing wire cloth over the gutters: America, gotta love it. And there's no OSHA inspector to worry about when you're the property owner as well as equipment operator.
I view it as exercise. If people don't need me to prep their data or fix their internet plumbing, I have other things to do (and it's possible someone will see the work and I get a side gig, it's happened before).
Ironically yesterday I was stapling wire cloth at the top of the stairs on the wooden deck because it gets slippery.
It is hard to find good handy help. They "repaired" a gutter by nailing it to the crown moulding, which is not structural (resulting in the failure of the fascia, but I digress); repaired copper supply lines with plastic; didn't tighten a slip ring on a sewer trap in the crawlspace. We just had a new roof put on, and overall they did a competent job but there is one leak, coming from a problem we explicitly paid them to solve, and getting that fixed is going real slow. The guy responsible for that aspect is obviously not a native english speaker; OTOH we prevailed on them to install some overhangs, and the carpenter worked with us and allowed us to paint the decking / sheathing / soffit which would be exposed before it was installed. During one of my burnouts I worked as an estimator for a high-end wood flooring company; literally over half of our competition was illegal, unlicensed, and sometimes part of an acknowledged criminal enterprise (not totally throwing shades at people who aren't from here, we had five crews and the Italian and the former Russian physicist (beautiful inlay work!) crew leads were class acts). But I digress.
I've done crazy shit my whole life, my dad died scuba diving at 52 (cause of death was inconclusive) but his brother lived into his 90s. A couple of years ago my father-in-law died after a fall; he was taking photographs in a park. Somehow when he fell he broke his neck; could have been a stroke, but he never really stabilized enough to find out, was dead within a week. He was in his 80s.
> I would assume it is because of the extra distractions now
... leading to loss of awareness of surroundings and smooth movement disruptions.
I very much agree with you that this most certainly is a factor in addition to the others listed in the article.
It is weird that the graphed increase grows steadily at presumably the same rate - there is no spike or bump or curve. I wonder if that indicates anything. Disregarding the shape of the graph, I would have guessed at a change in reporting instead. The steadily rising curve almost looks like something being gradually employed. At some point, the curve ought to change direction, if not before, then after the last person has fallen over.
Would be interested to see a breakdown of what type of falls these are. Falls in bathrooms, outside or on ice?
I can tell you from personal experience losing a lot of my mobility at a young-ish age, the bathroom is by far and away the most terrifying place for me, especially getting into and out of the shower. It was the first place I started installing safety mechanisms - wouldn't be surprised if bathroom falls are a significant percentage, and stairs.
I didn’t see this discussing whether falls have become more dangerous. How much of this is because the elderly fall more often and how much because, if they fall, they’re more likely to die?
If the latter, it seems the elderly have gotten worse at falling, possibly because they fall less at young age, and aren’t as good in breaking their fall as before.
And yes, it will be difficult to gather data on ”fell with little consequences”, but for the elderly, many falls will lead to doctor visits, so there likely is data on that.
The line between "falling" and "not falling" is extremely blurry for children- they will often do things like jump around, tuck and roll on the ground, hop like frogs and then scamper up the stairs on all fours and then flop down and roll around. Does that constitute a fall? Who knows. When i was young I remember reading on a form at a doctor's office "have you fallen in the last year?" And finding that an extremely humorous question. "Have you fallen in the last 5 minutes" would have been a more meaningful one but still very silly.
Even now at my age (40's) this fall I was crowd surfing at a car seat headrest concert in a black dress, and when I got to the front I was dropped in front of the stage, and then I stood up laughing and walked off to find my friends. Was that a fall? I don't know. Its just not really a question that makes sense when youre physically fit or young.
So yeah, i don't think that's it.
everyone be trippin'
If you are sharing facts like "Wisconsin falls are more deadly than Alabama falls", then you need to address the more obvious hypotheses that are conjured in the readers head. I found no mention of "ice" or "slippery", and instead the article blazed forward with its preferred explanation without providing evidence to dismiss the more obvious hypotheses.
>Another state-level predictor of accidental fall death rates is wintry weather: eight of the 10 states with the highest age-adjusted rates are notably snowy.
>Wisconsin, Maine, Vermont, Minnesota, Rhode Island, Iowa, New Hampshire, and South Dakota. The two states in the top 10 that are not notably snowy are Oklahoma and Oregon.
I have slipped on black ice in Portland OR.
bruised my tailbone bad enough to see a doctor after a slip on black ice in VA
Presumably because the Wisconsin-vs-Alabama differences have not significantly changed in the last few decades? Wisconsin has been a lot snowier than Alabama for a long time.
What's possibly more relevant is that Wisconsin has unusually high rates of alcohol abuse. Their high rate of fall-related deaths may be better understood as a high rate of alcohol-related deaths which involve falls.
https://pbswisconsin.org/news-item/wisconsins-death-grip-wit...
maybe because we now walk around with phones in our hands looking at screens. So when falling, we’re less prepared?
I’m surprised they didn’t mention increased social isolation.
They actually note the opposite of that, which is that fewer elderly people are living alone.
This might be evidence that the gravitational constant G is changing (increasing) over time! Could this be the explanation for dark matter and dark energy?
This would also explain why my bathroom scale has been showing larger and larger numbers to me! Genius. I'd say you're onto something, but I can't tell if you're also joking.
Occam's razor says it's less likely that the gravitational constant is increasing and more likely that the ability to withstand the pull of gravity decreases with age.
Article says age-adjusted fall rates are up substantially, so it's not just older population.
People rollerblade less.
I read that fall injuries in the elderly are a significant contributor to both death and drops in quality of life.
When it comes to proprioception and balance one group of people over 60 seem to have equivalent balance to younger people and that is certain kinds of rollerbladers.
So as a person who was relatively active (40mi+ per week biking and other things) I started rollerblading and it's been unbelievable, I'm older and certain types of movements that take 8yr olds a couple weeks to learn took me nearly a year, it's absolutely amazing though, pain and soreness in parts of my leg and feet all related to stabilization, significantly strengthened stabilization muscles and improved reaction times at speed. I figure if I can rollerblade on one foot at 15 miles an hour, walking with both feet at 3 should be no problem.
I put rollerblading and bouldering as my top two 'puzzle' based activities.
Yoga has balance poses and is much more accessible than rollerblading.
Yoga is a great idea but many who find it boring are getting the same poses at 15mph and with more dynamic load and interruption (due to rocks and other high speed road defects.) There is quite a bit of overlap but unless you are doing acro yoga there is also quite a bit that doesn't overlap.
Well of course old people fall more, but the article is about changes over the last 20 years.
...Oh wait, are you saying there are more old people now? That's interesting.
Which was specifically addressed early in the article.
Not only are there more falls among the elderly, there are more falls even fully accounting for changes in age composition of the population.
>>But an aging population only partially explains the rise in these deaths. Deaths by falls have risen 2.4-fold on an age-adjusted basis. While they have fallen among younger people and only risen slightly among the middle aged, they have risen substantially within every age bracket of the elderly.
It's back end of the post-war boom.
People look on their smartphones too much. They don't even look where they are walking anymore.
As a side note, I've gotten my dad into dirtbiking for the first time at 65.
He has padded shorts, and padding pants, and a padded shirt. He then wears my track leathers, even though he's on dirt. He's fallen a few times and he agrees you feel like superman.
He's started joking that if he makes it to 75, he's going to start wearing the padded shorts and shirt as regular daily wear.
I have always thought once I get to a certain age I might just start wearing a helmet...everywhere when standing. It will look silly, but maybe it's not such a bad idea.
Padded shorts with hip protection arent really visible in clothes. Wearing a helmet would make you look pretty crazy hah. But helmets are also designed to deal with impacts stronger than just falling over. For falls, people might do ok with just padded hats that were designed for just falls.
If I had to guess it would be people getting heavier, weaker, and more sedentary than the past.. making falls more likely.
Also people seem to like hard flooring lately instead of carpet. Even backyards are getting more cemented by the decade.
Also talker. And impact force increases with the square of distance so the extra height matters.
From sad experience with my own family - I'd also consider declining quality of treatment. Patients who fell may be neither cool nor lucrative for the medical-industrial complex. Also said complex protecting its own, by attributing some "oops, we goofed" deaths to falls.
> Third, it may be due to increased rates of obesity. A CDC study found that obesity increased the propensity for someone to fall in a laboratory setting. And obesity rates among people 60 and older rose from about 32.8% in 2001-2002 to 38.5% in recent years.
It's not just the chance of falling itself that warrants a look. More weight also means more energy dissipated.
On top of that, the problems with falls start to get really serious once fractures get into play [1].
What I can't find any data on is a change of floor material compositions. Anecdotally, I remember many of my older relatives having really soft carpets in their homes, while in more modern homes and even care institutions you will find hard material - hard carpet, wood, tiles or in institutions, straight concrete. All of these have the advantage that you can keep them clean and hygienic with far less effort - but damn, even as a younger person it hurts much more tripping over my cat when in areas with hard flooring. And they're slippery when wet!
For an older or obeser person, it sounds at least plausible that the flooring material contributes to more severe (and, consequentially, more fatal) fall events.
[1] https://www.rechtsdepesche.de/hohe-sterblichkeit-nach-gefaeh...
Could less physical labor lead to weaker bones or atrophied muscles leading to greater fall mortality?
I did an Ozempic stint and noticed my bone density had decreased to the bottom 3 percentile for my age, and I lost muscle as well.
It's all on me, of course, but I wonder if this phenomenon is widespread, and if it'll result in more deaths from falls.
Those two maps don't agree about Idaho.
Distraction by phones? (E.g. falls while taking deliberately dangerous selfie.)
Very old people are a larger proportion of the total population than before.
Now graph this against the rise of mobile devices…
Looking at the article's graphs - both the deaths and the increase in deaths are very strongly skewed toward the highest age brackets. Deaths fell in the 34-and-under brackets.
Are 85+ folks falling more (or worse), because they're paying more attention to their phones than to their feet? Or maybe the fatal falls are caused by collisions with nose-in-phone kids?
Fall fatalities for people 25-34 are likely related to working at height or recreational climbing, during which the victim is less likely to be using electronic devices.
E-bikes?
The CDC separates pedal cyclist causes of death from fall causes, so they wouldn't be reflected in this data.
Idiocy?
Lots of new pastimes involve climbing up, diving off, or jumping between very tall things.
Usually with some sort of recording/streaming device strapped to the hobbyist.
The article says death rates from falls in younger people has declined.
People fall because the surroundings are unfamiliar, their trust and assumptions about things around them, and about themselves, have gone wrong. Why does this discrepancy arise? For older people, the world around them and food they eat has changed too fast, to the extent of being an alien land. They walk on a surface, making assumptions based on what they were familiar with in the past. But the surface is no longer the same. They eat the changed food, assuming that it will keep them as strong as before. That turns out to be false as well. Most old people feel that they are living in a world that is completely unfamiliar and untrustworthy.
I think this can be seen here up north, where people fall through ice and drown every fall and (more commonly) spring. It's not a new thing – these people are almost always male, at least in their 50s, alone on the ice, and taking stupid unnecessary risks trying to reach their favorite ice fishing spot or whatever – but I can't help but think that increasingly these deaths are caused by assumptions that the ice is strong enough because it has "always been at this time of the year". Except that it isn't, not anymore. Or even if it is this year, the annual variance is much greater.
The rise is independant of age, but with younger people even greater.
Other than that, is that some ai-slop-comment?
Ofcourse, it applies to younger people as well. I didn't exclude them.
Other than, if it sounds like "ai slop" to you, you probably did not expect a properly written statement from real people. It gotten to a point someone saying real world experience witnessed by me as "ai slop". This HN land became unfamiliar alien land to me now. Do I need to force myself to sound trivial, incorrect, slangish?
This is so disconnected from the real world that it has to be ai, because I don't want to think someone on this platform can be so ridiclious.
And the disconnection is .. ? Infact, forget it. Your comment proves that this is already at ridiculous level. The message I posted about alienation of old people with the changing world, close to my heart than anything else, as I went through painful experiences that lasted for decades.
And now treading the slippery slope of social forums of HN, where the floor suddenly slips and we fall into getting called as "ai-written". This world is done.