Dr. Steven Rigatti, Consulting Medical Director to CRL, comments on a study showing how death rates caused by falls have increased over the past 20 years.
A recent letter in the Journal of the American Medical Association[i] shows that falls, as a cause of death, have risen markedly over the last 20 years. The authors used the CDC WONDER database to obtain age-adjusted death rates for those aged 65 years or older in the United States. Rates of death were split by sex and race. The mortality ratio for fall-related deaths in 2020 relative to 1999 was 2.36 – meaning the rate of fall-related deaths more than doubled in that time.
This mortality ratio was higher for females (2.49) than for males (2.14), and it was higher for whites (2.55) than for other racial/ethnic groups (African Americans: 1.91, Native Americans: 1.76, Asian/Pacific Islanders: 1.66, and Hispanic: 1.73).
The authors suggested that some of this increase may be due to improved quality of death records over time, but they also point out that other studies have confirmed this trend of rising deaths from falls.
In order to make these findings more relevant to the life insurance population, the CDC WONDER database was queried, and the results limited to the 100 American counties with the highest per-capita income – eliminating those with a population of at least 100,000. The results were split by age group.
These results suggest that this trend persists in a population more akin to purchasers of life insurance. It also shows that the findings of the original study, which used a 65+ age group, were likely driven by the older segment of that age range.
Increasing mortality from falls is a worrying trend with no obvious driving force. Life insurers may wish to consider more robust ways to evaluate fall risk in older applicants, or to help drive healthier exercise and safety habits in their in-force pool.
About the Author
Dr. Steven J. Rigatti is a consulting medical director with Clinical Reference Laboratory, with 12 years’ experience in the life insurance industry. He is the current chair of the Mortality Committee of the American Academy of Life Insurance Medicine.
[i] Santos-Lozada, AR. Trends in Deaths From Falls Among Adults Aged 65 Years or Older in the US, 1999-2020. JAMA. 2023;329(18):1605-6.