Commentary: Working toward a Multi-Program Strategy in Fall Prevention

Falls among older adults are a critical public health issue, especially given the high rate of falls among older adults, the rapidly increasing number of older adults (both in the US and globally), and their substantial personal and societal costs (1, 2). In response, a national movement in the US toward a falls free society is underway (3, 4). According to Lynn Beattie’s commentary “Working toward a Multi-Program Strategy in Fall Prevention” (2015), “there is an inextricable link among aging processes, chronic diseases, and fall risks” (5). Yet, Beattie raises unanswered questions such as whether we can “consider a multi-program longer-term community strategy that helps to maintain behavior change, promotes physical activity, and helps to better manage medications and chronic conditions as a longer term fall prevention strategy.” This commentary reflects on a statewide strategy that considers risks, public health concerns, the structure and functioning of coalitions, and policy and programmatic impacts, and addresses Beattie’s question. As illustrated in Figure 1, the major risks for falls and chronic conditions are often similar involving biological, behavioral, and environmental factors. While both falls and chronic conditions are interrelated and have similar roots, public health solutions are diverse in stakeholder engagement and strategies. For example, under the leadership of the National Council on Aging, there are state fall prevention coalitions in most (n = 46) states that promote and implement multilevel fall prevention strategies (6, 7). Similarly, the National Association of Chronic Disease Directors works through state and community partners to focus on solutions that help ameliorate chronic disease burden by addressing modifiable risk factors.1 The Texas Falls Prevention Coalition (TFPC) was established in 2007 and revitalized in 2014 with new leadership at the Center for Population Health and Aging (8, 9). It consists of nearly 200 members driven by a steering committee of 14 professionals representing aging services, clinical practice and healthcare organizations, state government, and academia.2 Following the 2015 Falls Free® National Falls Prevention Action Plan (10, 11), TFPC’s major goals are to: • Increase awareness of the issue and effective prevention strategies. • Increase provider participation in fall prevention practices. • Increase the availability and accessibility of community programs and services.