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Journal of Medical Systems
Published in: Journal of Medical Systems 6/2011

01-12-2011 | Original Paper

A Small-Area Study of Environmental Risk Assessment of Outdoor Falls

Authors: Poh-Chin Lai, Wing-Cheung Wong, Chien-Tat Low, Martin Wong, Ming-Houng Chan

Published in: Journal of Medical Systems | Issue 6/2011

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Abstract

Falls in public places are an issue of great health concern especially for the elderly. Falls among the elderly is also a major health burden in many countries. This study describes a spatial approach to assess environmental causes of outdoor falls using a small urban community in Hong Kong as an example. The method involves collecting data on fall occurrences and mapping their geographic positions to examine circumstances and environmental evidence that contribute to falls. High risk locations or hot spots of falls are identified on the bases of spatial proximity and concentration of falls within a threshold distance by means of kernel smoothing and standard deviational ellipses. This method of geographic aggregation of individual fall incidents for a small-area study yields hot spots of manageable sizes. The spatial clustering approach is effective in two ways. Firstly, it allows visualisation and isolation of fall hot spots to draw focus. Secondly and especially under conditions of resource decline, policy makers are able to target specific locations to examine the underlying causal mechanisms and strategise effective response and preventive measures based on the types of environmental risk factors identified.
Literature
1.
Albert, D. P., Gesler, W. M., and Levergood, B. Geographical information systems in health services research. In: Albert, D. P., Gesler, W. M., and Levergood, B. (Eds.), Spatial analysis, GIS, and remote sensing applications in the health sciences. Ann Arbor, Chelsea, pp. 55–75, 2000.
2.
Bailey, T. C., and Gatrell, A. C., Interactive spatial data analysis. Wiley, New York, 1995.
3.
Basara, H. G., and Yuan, M., Community health assessment using self-organizing maps and geographic information systems. Int. J. Health Geogr. 7:67, 2008.CrossRef
4.
Bath, P. A., and Morgan, K., Differential risk factor profiles for indoor and outdoor falls in older people living at home in Nottingham, UK. Eur. J. Epidemiol. 15(1):65–73, 1999.CrossRef
5.
Bergland, A., and Wyller, T. B., Risk factors for serious fall related injury in elderly women living at home. Inj. Prev. 10(5):308–313, 2004.CrossRef
6.
Carter, S. E., Campbell, E. M., Sanson-Fisher, R. W., Redman, S., and Gillespie, W. J., Environmental hazards in the homes of older people. Age Ageing. 26(3):195–202, 1997.CrossRef
7.
Chan, B. K. S., Marshall, L. M., Winters, K. M., Faulkner, K. A., Schwartz, A. V., and Orwoll, E. S., Incident fall risk and physical activity and physical performance among older men: the osteroporotic fractures in men study. Am. J. Epidemiol. 165(6):696–703, 2006.CrossRef
8.
Chu, L. W., Chi, I., and Chiu, A. Y. Y., Incidence and predictors of falls in the Chinese elderly. Ann. Acad. Med., Singap. 34(1):60–72, 2005.
9.
Chu, L. W., Chi, I., and Chiu, A. Y. Y., Falls and fall-related injuries in community-dwelling elderly persons in Hong Kong: a study on risk factors, functional decline, and health services utilisation after falls. Hong Kong Med. J. 13(Supplement 1):8–12, 2007.
10.
Cromley, E. K., and McLafferty, S. L., GIS and public health. Guilford, New York, 2002.
11.
Curtis, A., and Leitner, M., Advanced spatial analysis. In: Curtis, A., and Leitner, M. (Eds.), Geographic information systems in public health: eliminating perinatal disparity. Ann Arbor, Chelsea, pp. 174–194, 2005.CrossRef
12.
Diggle, P., Statistical analysis of spatial point patterns. Oxford University Press, New York, 2003.MATH
13.
Douven, Q., and Scholten, H. J., Spatial analysis in health research. In: de Lepper, M. J. C., Scholten, H. J., and Stern, R. M. (Eds.), The added value of geographical information systems in public and environmental health. Kluwer Academic, Boston, pp. 117–133, 1995.
14.
Everitt, B. S., Landau, S., and Leese, M., Cluster analysis. Oxford University Press, New York, 2001.MATH
15.
Fletcher, P. C., and Hirdes, J. P., Risk factors for falling among community-based seniors using home care services. J. Gerontol.: Med. Sci. 57A(8):M504–M510, 2002.CrossRef
16.
Gao, S., Mioc, D., Anton, F., Yi, X., and Coleman, D. J., Online GIS services for mapping and sharing disease information. Int. J. Health Geogr. 7:8, 2008.CrossRef
17.
Gibson, M. J., Andres, R. O., Isaacs, B., Radebaugh, T., and Worm-Petersen, J., The prevention of falls in later life. A report for “Kellog International Work Group on the Prevention of Falls by the Elderly”. Dan. Bull. 34(4):1–24, 1987.
18.
Gordon, A., and Womersley, J., The use of mapping in public health and planning health services. J. Public Health Med. 19(2):139–147, 1997.
19.
Guelich, M. M., Prevention of falls in the elderly: a literature review. Top. Geriatr. Rehabil. 15(1):15–25, 1999.
20.
Hill, K., and Schwarz, J., Assessment and management of falls in older people. Intern. Med. J. 34(9–10):557–564, 2004.CrossRef
21.
22.
Kaneko, Y., Takano, T., and Nakamura, K., Visual localisation of community health needs to rational decision-making in public health services. Health Place 9(3):241–251, 2003.CrossRef
23.
Kelly, K. D., Pickett, W., Yiannakoulias, N., Rowe, B. H., Schopflocher, D. P., Svenson, L., and Voaklander, D. C., Medication use and falls in community-dwelling older persons. Age Ageing. 32(5):503–509, 2003.CrossRef
24.
25.
Lai, P. C., Wong, C. M., Hedley, A. J., Lo, S. V., Leung, P. Y., Kong, J., and Leung, G. M., Understanding the spatial clustering of severe acute respiratory syndrome (SARS) in Hong Kong. Environ. Health Perspect. 112(15):1550–1556, 2004.CrossRef
26.
Lai, P. C., So, F. M., and Chan, K. W., Spatial epidemiological approaches in disease mapping and analysis. CRC, Taylor & Francis Group, Boca Raton, 2009a.
27.
28.
29.
Lawson, A. B., Statistical methods in spatial epidemiology. Wiley, Chichester, 2006.MATH
30.
Levine, N., CrimeStat: a spatial statistics program for the analysis of crime incident locations, vol. 3.1. Ned Levine & Associates, Houston, TX, and the National Institute of Justice, Washington, DC, 2007.
31.
Li, W., Keegan, T. H. M., Sternfeld, B., Sidney, S., Quesenberry, C. P., Jr., and Kelsey, J. L., Outdoor falls among middle-aged and older adults: a neglected public health problem. Am. J. Public Health. 96(7):1192–1200, 2006.CrossRef
32.
Li, F., Harmer, P., Cardinal, B. J., and Vongjaturapat, N., Built environment and changes in blood pressure in middle aged and older adults. Prev. Med. 48:237–241, 2009.CrossRef
33.
Lord, S. R., Sherrington, C., and Menz, H. B., Falls in older people: risk factors and strategies for prevention. Cambridge University Press, United Kingdom, 2001.
34.
Low, C. T., An exploratory study of environmental risk factors to elderly falls in Hong Kong—A GIS case study of Mong Kok, 2006–2007. Mphil Thesis. Department of Geography, The University of Hong Kong, 2008.
35.
Lui, S. K., An ethnographic comparison of wet markets and supermarkets in Hong Kong. The Hong Kong Anthropologist. 2:1–52, 2008.CrossRefMathSciNet
36.
Luo, W., Using a GIS-based floating catchment method to assess areas with shortage of physician. Health Place. 10(1):1–11, 2004.CrossRef
37.
Moore, D. A., and Carpenter, T. E., Spatial analytical methods and geographic information systems: use in health research and epidemiology. Epidemiol. Rev. 21(2):143–161, 1999.
38.
Patil, G. P., and Taillie, C., Geographic and network surveillance via scan statistics for critical area detection. Stat. Sci. 18(4):457–465, 2003.CrossRefMATHMathSciNet
39.
Quandt, S. A., Stafford, J. M., Bell, R. A., Smith, S. L., Snively, B. M., and Arcury, T. A., Predictors of falls in a multiethnic population of older rural adults with diabetes. J. Gerontol. 61A(4):394–398, 2006.
40.
Rubenstein, L. Z., Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 35(S2):ii37–ii41, 2006.CrossRef
41.
Rubenstein, L. Z., Robbins, A. S., Josephson, K. R., Schulman, B. L., and Osterweil, D., The value of assessing falls in an elderly population: a randomized clinical trial. Ann. Intern. Med. 113:308–316, 1990.
42.
Rushton, G., and Lolonis, P., Exploratory spatial analysis of birth defect rates in an urban population. Stat. Med. 15(7–9):717–726, 1996.CrossRef
43.
Sabel, C. E., Gatrell, A. C., Löytönen, M., Maasilta, P., and Jokelainen, M., Modeling exposure opportunities: estimating relative risk for motor neurone disease in Finland. Soc. Sci. Med. 50(7–8):1121–1137, 2000.CrossRef
44.
Seymour, J., Cairns, J., Wilkie, A., Sandercock, P. A. G., and Wardlaw, J. M., Geographical access to imaging facilities for stroke patients in Scotland. Health Place. 12(4):617–630, 2005.CrossRef
45.
Shortt, N. K., Moore, A., Coombes, M., and Wymer, C., Defining regions for locality health care planning: a multidimensional. Soc. Sci. Med. 60(12):2715–2727, 2005.CrossRef
46.
Silverman, B. W., Density estimation for statistics and data analysis. Chapman and Hall, London, 1986.MATH
47.
Sridharan, S., Tunstall, H., Lawder, R., and Mitchell, R., An exploratory spatial data analysis approach to understanding the relationship between deprivation and mortality in Scotland. Soc. Sci. Med. 65(9):1942–1952, 2007.CrossRef
48.
Sze, P. C., Lam, P. S., Chan, J., and Leung, K. S., A primary falls prevention programme for older people in Hong Kong. Br. J. Community Nurs. 10(4):166–170, 2005.
49.
50.
Vieira, V. M., Webster, T. F., Weinberg, J. M., and Aschengrau, A., Spatial-temporal analysis of breast cancer in Upper Cape Cod, Massachusetts. Int. J. Health Geogr. 7:46, 2008.CrossRef
51.
Wakefield, J. C., Kelsall, J. E., and Morris, S. E., Clustering, cluster detection, and spatial variation in risk. In: Elliott, P., Wakefield, J., Best, N., and Briggs, D. (Eds.), Spatial Epidemiology Methods and Applications. Oxford University Press, New York, pp. 128–152, 2004.
52.
Waller, L. A., and Gotway, C. A., Applied spatial statistics for public health data. Wiley, New Jersey, 2004.CrossRefMATH
53.
Wang, S. Y., and Wollin, J., Falls among older people: identifying those at risk. Nurs. Older People. 15(10):14–16, 2004.
54.
Yiannakoulias, N., Rowe, B. H., Svenson, L. W., Schopflocher, D. P., Kelly, K., and Voaklander, D. C., Zones of prevention: the geography of fall injuries in the elderly. Soc. Sci. Med. 57:2065–2073, 2003.CrossRef
Metadata
Title
A Small-Area Study of Environmental Risk Assessment of Outdoor Falls
Authors
Poh-Chin Lai
Wing-Cheung Wong
Chien-Tat Low
Martin Wong
Ming-Houng Chan
Publication date
01-12-2011
Publisher
Springer US
Published in
Journal of Medical Systems / Issue 6/2011
Print ISSN: 0148-5598
Electronic ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-010-9431-1

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