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Active Living
Full Listing with story descriptions
A Healthy Balance
Ankle Sprains
Active Kids, Healthy Kids
Active Kids in Winter
Athletic Skin Infections
Children, Nutrition & Exercise
Beat the Heat!
Cold Weather Workouts
Concussions
Core Stability
Cross Country Skiing
Exercise and Disabilities
Exercise and Menstrual Irregularities
Exercise in the Cold
Exercise in the Heat
Exercise is Medicine
Exercise Options
Exercising in Pregnancy
Female Athletes
FITT Prescription
Footwear for Running
From Surviving to Thriving
Flexibility
Gadgets & Gizmos
Get Moving!
Get Motivated
Golf Exercises
Golf Injury Prevention
Head Injuries
Hockey Injuries
Home Gyms
Immunization
Jump Start Weight Loss
Knee Cap Pain
Knee Ligament Injuries
Live Actively
Low Back Pain
Osteoporosis & Exercise
Osteoarthritis
Osteoarthritis of the Knee
Plantar Fasciitis
Prehistoric Workout
Prevention of Sports Injury
Proprioception
Recreational Safety Equipment
Running
Safe Snow Shovelling
Shin Splints
Ski Conditioning
Shoes & Fit
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Sore Shoulder
Spinal Cord Injuries
Staying Active
Staying Fit in the Cold
Sports Nutrition & Supplements
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Swimming Injuries
Teen Sports Injuries
Walking
Water and Exercise
Weight Training
7 Wonders of Walking
Adolescent Health
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Acne
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Adolescent Growth & Development
Body Image
Body Piercing
Bullying
Chronic Diseases in Teens
Communications Skills
Concussion in Sport
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Dangers of Artificial Tanning
Depression
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Female Physical Exam
First Period
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Mononucleosis
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Teens & Exercise
A Woman's Physical
Your First Job
Youth Violence
Childbirth
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Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
Birthing Etiquette
Birth Plans
Birthing Procedure Trends
Bleeding in Pregnancy
Breastfeeding Benefits
Caesarean Section by Request
Care for the New Mother
Cord Blood Banking
Delaying Motherhood
Blue after Baby or Postpartum Depression
Diabetes in Pregnancy
Eating Well for Pregnancy
Evolving Ideas about Pregnancy and Birth
Exercise in Pregnancy
Flying During Pregnancy
Folic Acid in Pregnancy
High Blood Pressure in Pregnancy
Getting a latch on breastfeeding
Group B Streptococcus
Induction of Labour
Infections During Pregnancy
Intrauterine Growth Restriction (IUGR)
In-Vitro Fertilization
Low Birth Weight Babies
Medication & Pregnancy
Miscarriage
Managing Your Own Labour
Monitoring Your Labour
Nausea & Vomiting in Pregnancy
Pain Relief in Labour
Prenatal Classes
Preterm Labour
Planning a Pregnancy
Pregnancy Weight
Prenatal Care Providers
Postpartum Repetitive Strain Injuries
RH Disease
Rupture of Membranes Before Labour
Sex During Pregnancy
Skin Changes in Pregnancy
Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun & Photos
Natural Remedies in Pregnancy
Vaccinations During Pregnancy
Vacuum & Forceps for Delivery
Vaginal Birth After Caesarean
When Baby Comes Home
Childhood
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Asthma in Children
Attention Deficit Disorder
Babysitter
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Chickenpox
Childcare Options
Children's Headaches
Childhood Obesity
Choosing A Babysitter
Circumcision
Colds & Flu
Common Childhood Skin Infections
Croup
Developmental Milestones
Diaper Rash
Daytime Wetting
Introducing Solid Foods
Developmental Co-ordination Disorder
Diarrhea
Discipline
Earache
Eczema
Feeding Your Baby
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Fever
Head Lice
Hearing
How Children Grow
Hearing Loss
Hearing Issues in Newborns
Heart Murmers
Hip Clicks
Influenza
Iron
Is it an Emergency?
Children and Sports Injuries
Lazy Eye (Amblyopia)
Learning Disabilities
Leg Problems
Not Just Baby Fat
Orthodontics
Preparing for Lab Tests
Recognizing Learning Disabilities
Red Rashes
RSV-Childhood Respiratory Virus
Safe Summer Fun
School
Scoliosis
Sick Toddler
Sleep Struggles
Sniffles, Fevers, Rashes & Coughs
Sore Throats
Speech Problems
Strep Throat
Toddler Safety
Thumbsucking
Tooth Injuries
Tummyache
Urinary Tract Infections
Vaccinations
Vaccination and Autism
When to go to the Doctor
Whooping Cough
Worried Sick
Yeast Infections in Children
Chronic Pain
Full Listing with story descriptions
Introduction
Managing Your Pain
Movement Matters
Moving Forward
Nutrition
Opioids
Pacing
Pain Medications
Prevention
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
Full Listing with story descriptions
Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
Bad Breath (Halitosis)
Children's Dental Injuries
Choosing a Dentist
Cosmetic Dentistry
Mouth Guards
Dental Exam
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Dental Care Offshore
Dental Implants
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Dentures and Healthy Jaw
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Fluoride
Fluoride Findings
First Dental Visit
Headaches
A Healthy Mouth
Healthy Mouth, Healthy Body
Jaw Joint and Muscle Problems
Keeping it Clean
Laser Use in Dentistry
Mouth Protection Equipment
Oral Cancer Screening
Oral Healthcare
Oral health and long term care
Oral Health Care Products
Orthodontics
Orthodontist First Visit
Painless Dentistry
Periodontal Disease
Removable Dentures
Root Canal
Seniors Oral Care
Sensitive Teeth
The Smile You Want
Sore Mouth, Aching Jaw
Snoring and Sleep Apnea
Smiling through the Senior Years
Teeth for Life
Temporomandibular Disorders (TMD)
Tobacco Risks to Oral Health
Tongue Piercing
Tooth Whitening
Travel Dentistry
Water Fluoridation
Wisdom Teeth
Your Healthy Smile
DIABETES
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10,000 Steps
A1C Test
Accurate Blood Glucose Testing
Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
ASA Therapy
Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Glucose Testing Tips
Blood Sugar Lows
Blood Glucose Monitors
C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
Diabetes Diet
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
Diabetes and Your Eyes
Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fats
Fibre
Fill Your Day with Energy
Financial Support for Diabetes
Food Temptation
Foot Care
Footwear and Foot Health
Fruits and Veggies
Gastroparesis
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
Insulin Handling
Insulin - the Key to Energy Management
Insulin Pumps
Insulin Pen Needles
Insulin Pump Infusion Sets
Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
Insurance
Ketones
Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Metformin
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
Microalbuminuria
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Over-the-Counter Medications
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Sodium
Social Media & Diabetes
Solving the Insurance Puzzle
Stress and Diabetes
Success in School
Supplements
Supporting Spouse with Diabetes
Sweeteners
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Traveling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Understanding Ketones
Used Sharps
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Walking
Wise Choices About Natural Medicines
Wonderful Water
Natural Medicines & Diabetes
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
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ADHD in Children
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Allergies
Antibiotic Use
Arthritis
Aspirin Every Day?
Asthma
Back Pain
Back Pain Myths
Back Pain - Lower
Birth Control
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Check-Up
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Contact Lenses
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Cost of Doctor's Visit
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Diagnostic Tests
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Doctor Visit
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Does My Sore Knee Require an MRI?
Do I Need an Annual Physical?
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Family Doctor
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5 Ways to Stay Healthy
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Get Active!
Glare
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How to Talk to Your Doctor
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Medical Digital Technology
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Stroke
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Win by Losing
Urinary Tract Infections
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First Aid
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Bites and Stings
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First Aid Travel Kit
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Emergency Care Guidelines
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Growing Older
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Get Active!
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Have Health, Will Travel
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Canada's New Blood System
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Diabetes Epidemic
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Schizophrenia
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Soy
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Swim to Survive
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5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
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Breakfast is Important
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Building Your Bones
Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
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Energy Drinks
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Food for Active Kids
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Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
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Healthy Eating on Business Travel
Healthy Ethnic Meals
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Fats
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Feeding Your Kids
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Food Chemistry 101
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Healthy Eating for Teens
Healthy Habits
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New Ingredients for Your Shopping Cart
Iron
Kid's Food
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Mercury Levels in Fish
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H1N1 Virus - Plan Ahead
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15 Great Reasons to Breastfeed
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Family Health Magazine - prevention

Injury Prevention
Much ado about something

Stephen, 20 years old, is driving his truck home from a friend’s party on a Saturday night. He’s had a few drinks but assures himself that any effect of the alcohol has worn off by now. He is not wearing his seatbelt. He thinks it is too uncomfortable and there is little chance that the cops will be checking for seatbelts at this hour. A bit sleepy, Stephen wants some loud music to perk him up. He leans over the passenger side of his truck to rummage through his CDs. He finds the one he is searching for and focuses back on the road, too late. He is approaching a stop sign at 80 kilometres per hour. Stephen’s truck hits another vehicle driving through the intersection. The impact of the crash throws Stephen from his seat, through the windshield, and onto the road. He lands 15 feet in front of his truck. A witness calls an ambulance. Both drivers are taken to the nearest emergency department. Among many cuts, bruises, and sprains, Stephen has broken his back and is paralyzed from the waist down. The other driver is dead. And we call this an accident?

Sarah is 72 years old and lives by herself. She is very independent and likes to keep busy. She spends a lot of time playing cards and chatting with the ladies down at the community hall. The stairs leading up to the hall are a bit rickety and don’t have a banister. Today, Sara has brought cinnamon buns and raspberries from her garden to share with the group. As she rushes up the rickety stairs of the hall carrying the box full of treats, she stumbles on an uneven step. She loses her balance and falls to the ground. She has a broken hip and arm, and is in hospital for weeks. When Sara first returns home, she needs nearly constant care. She finds it difficult to get around and do all the things she is used to doing. Sara is also afraid of falling again and stops going out as much. Her health gets worse and within the year she must go into a nursing home. And we think this could not be prevented?

Prevention – much ado about something!

The truth is, an injury is no accident. Most injuries can be predicted and prevented. Yet injuries continue to be the number one cause of death and disability among Canadians under the age of 40. This year in Canada, more people in this age group will die of an injury than from AIDS, cancer, and heart disease combined.

Stephen and Sara’s stories describe two of the most common types of injuries in Canada. Together with suicide, motor vehicle collisions (MVCs) and falls account for over 70 per cent of deaths related to an injury. Every year, over 3,500 Canadians die by suicide, about 3,000 die in MVCs, and nearly 2,700 die because of a fall. These deaths are a fraction of the large number of people who have spent time in hospital in recent years because of an injury. More than 250,000 Canadians are hospitalized annually because of an injury. Over two-thirds of these are a result of a self-inflicted injury, an MVC, or a fall.

All of us are at risk of injury. However, the degree of risk and impact of an injury can vary greatly by age, sex, region, income group, and type of injury. Men have higher rates of injury than women. Young people are at higher risk of injury from motor vehicle collisions. Older adults are at higher risk of injury from falls. First Nations people have higher rates of injury overall than other groups. In general, lower income groups tend to have a higher risk of a fatal injury than higher income groups.

The costs of injuries are shocking – both in human and economic terms. Direct economic costs of major unintentional injuries in Canada are estimated to be more than $4.2 billion each year. The indirect costs are estimated to exceed $4.5 billion. This says nothing about the impact these injuries have on an injured person’s family, workplace, and other responsibilities.

Where does all this leave us? We know injuries are predictable and preventable. We know how much pain and suffering they cause. We know how much they cost us. But what are we doing to prevent them?

Preventing motor vehicle collisions

Unfortunately, Stephen’s story is all too common. In 1999, in the four western provinces of Canada, there were 191,790 motor vehicle collisions reported. These resulted in 1,060 deaths and over 73,000 non-fatal injuries. And that is just in one year.

Stories like Stephen’s are common in all parts of Canada. MVC injuries and deaths commonly include young men, alcohol, speed, no seatbelts, and distractions while driving. Of all age and sex groups, young men aged 20 to 24 years have the highest rates of MVC deaths, emergency department visits, and hospitalization. What may be more tragic and frustrating is that most MVCs can be avoided. There are proven ways to prevent the number of collisions and the seriousness of resulting injuries.

Speeding is the leading cause of severe injuries and death due to collisions. Enforcing roadway speed limits is critical to reducing speeds and injuries. Wearing a seatbelt in a collision reduces the chance of being killed by 55 per cent.

Graduated Drivers’ Licensing (GDL) programs are another strategy designed to help new, inexperienced drivers. The idea is to create better drivers and reduce injuries through a three-phase apprenticeship program. A number of regions across North America including Alberta and British Columbia have GDL programs. A recent review found that these programs help reduce crash rates of young, new drivers, a high-risk group for collisions.

Other strategies for preventing injuries include using special car seats for children, requiring helmets for motorcyclists, and reducing drunk driving. There are the common sense driving practices -- slowing down, obeying traffic signals, and following the rules of the road. It is also important to avoid distractions such as talking on cell phones or eating while driving.

Positive effects from programs to reduce the number and seriousness of collisions have already been seen. In the Capital Health Region (Edmonton area) of Alberta, prevention efforts have helped reduce MVC deaths. In 1985, the MVC death rate was 14.9 per 100,000 for males and 8.1 for females. In 1999, the rate decreased to 5.7 deaths per 100,000 males and 3.5 for females. Although we still have a long way to go, these programs have saved hundreds of lives and prevented thousands of injuries. As well, billions of dollars have been saved on health care, property damage, and costs to society.

Preventing falls

Like collisions, falls are a major health concern, especially for older adults. Data suggest that Sara’s fall is far from being unusual. Among people aged 65 and older, falls are the leading cause of death from an injury, hospitalization and visits to Emergency. More older adults are hospitalized because of a fall than for all other types of injury combined, including MVCs, unintended poisonings, and assaults. In 1999, Albertans aged 65 and older made over 14,000 visits to Emergency due to a fall. As well, over 5,000 Albertans (aged 65+) spent time in hospital, and 52 died because of a fall. Women experienced 67 per cent of the fall-related Emergency visits and 68 per cent of the hospitalizations.

The cost of falls among older adults is huge. It is estimated that in Canada, over $980 million is spent treating falls among older adults every year. Older adults injured in a fall are much more likely to use health care services in the following year, compared to those who have not fallen. Falls and the associated fear of falling affect older adults’ health, quality of life, mobility, and independence. Falls also account for 40 per cent of admissions to nursing homes, and a 10 per cent increase in the use of home care services.

Yet falling is often considered a ‘normal’ part of aging. There is nothing normal about these falls among older adults or their results. Falls are usually preventable. There are ways to reduce or remove the risk of falling. These in turn can reduce the number and seriousness of falls.

As with Sara, falls are usually not the result of a single cause. Any approach to fall prevention must be thorough. Healthy aging strategies, reducing risks, and creating safe environments are all necessary and possible. Improving physical activity, strength, balance, and flexibility among older adults helps to prevent falls and lessen the seriousness of an injury related to a fall. Other personal risk factors for falls include not paying attention, drinking, and taking many prescription medications. Risk factors in the environment, such as uneven surfaces, poor lighting, a lack of banisters, and other slip and trip factors must also be addressed.

The success of fall prevention efforts can be seen in the data. In the Capital Health region of Alberta, these efforts have contributed to a decline in deaths from falls. In 1994, the overall death rate from falls was 5.7 per 100,000. By 1999, the rate decreased to 3.1 per 100,000. Remember that the number of deaths resulting from a fall is a fraction of the number of hospitalizations and visits to Emergency. There remains much to be done in fall prevention.

Safe environments need co-operation

Injuries are a major health concern resulting in huge costs to the health care system and society. However, injury prevention requires more than simply asking people to be careful. It requires effort by political representatives and those working in the injury prevention and control areas. Urban planners, builders, engineers, police, and citizens are also involved. We must work together to create a safe environment for everyone.

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FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
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