Health of Older Adults in New York City Public Housing: Part 2, Findings From the New York City Housing Authority Senior Survey

Abstract

UNINTENTIONAL INJURIESUnintentional injuries, or accidents, are common among older adults and can lead to long-term disability and even death. However, injuries are preventable and should not be considered a normal part of aging.Recent FallsFalls, the most common cause of injury among older adults nationally and in NYC, result from a complex set of factors including loss of gait and balance, environmental hazards, the use of multiple medications, and vision problems.1,2 Comparable to national estimates among adults aged 65 and older3 three in 10 (29%) older NYCHA residents reported a recent fall. Unlike the prevalence of falls in the US, which are more commonly reported among women than men and increase in prevalence with age, the prevalence of recent falls among older NYCHA residents did not vary by gender or age.3 Black residents reported fewer recent falls than white and Hispanic residents, and older residents living alone were more likely to report a recent fall than those living with others.Falls can be caused by current disability but can also contribute to disabling conditions and poor quality of life.2,4 Adults who have experienced a fall may also develop a fear of falling that causes them to limit their physical activity and become isolated. This, in turn, decreases physical and mental health and increases risk for future falls.2,4 Similar to older adults nationally,2 older NYCHA residents who reported a recent fall were more likely to report being physically inactive than those who did not (39% vs. 27%). Severe vision trouble, a risk factor for falling,2,4 was also associated with recent falls among older NYCHA residents: those with severe vision trouble were more likely than those without to report a recent fall (36% vs. 26%).Chronic health conditions, whether the condition itself or the side effects of prescribed medication to treat the condition, have been associated with an increased risk of falling.3 Older residents diagnosed with multiple chronic conditions were more likely to report a recent fall than those with one or no conditions (32% vs. 13%). Additionally, older NYCHA residents who had a heart attack or stroke within the past five years were twice as likely as those who did not to report a recent fall (53% vs. 26%).Accidental BurnsIn 2009, there were more than 23,000 unintentional burn-related injuries among adults aged 65 and older in the US.1 Age-related factors, such as mobility and vision impairments, comorbid medical conditions, and medications, can put older adults at increased risk for burn-related injuries.2,3 Among older NYCHA residents, 9% reported an accidental burn in the past three months. Being diagnosed with multiple chronic conditions was associated with a higher prevalence of accidental burns among older residents, but the prevalence of burns did not vary by demographic subgroups.Social and behavioral factors play an important role in burnrelated injuries among older adults. Smoking poses a significant risk, as lit cigarettes can cause burns on the skin and ignite textiles such as clothing or bedding.3 Among older NYCHA residents, accidental burns were almost twice as common among current smokers as nonsmokers (14% vs. 8%).Key Findings: Unintentional Injuries* The prevalence of recent falls among older NYCHA residents was comparable to national prevalence estimates among older adults. However, unlike national estimates of falls, falls among older NYCHA residents did not vary by age or gender. Among older NYCHA residents, groups at high risk for falls included those with a history of heart attack or stroke, and those living alone.* Almost one in 10 older NYCHA residents suffered an accidental burn in the past three months, and accidental burns were almost twice as common among current smokers as nonsmokers.HEALTH INSURANCE AND ACCESS TO HEALTH CAREMany factors can affect an individual's ability to obtain appropriate and needed care. …