Wednesday, November 17, 1999

One explanation for falls: pride


Local reporting methods are also cited

BY TIM BONFIELD
The Cincinnati Enquirer

        Vern Ellenberger has one idea about why Hamilton County has a high rate of senior citizens dying from fall-related injuries — too many seniors resist making the changes needed to live a safer life.

        On Monday, a Hamilton County injury surveillance study reported that the local rate of fatal injuries from falls was more than double the national average.

        In addition, the study showed that 67 of the 97 fall-related deaths involved people over 75. Now, the question is: Why are the rates so high here?

        Some experts say it may be a statistical quirk — Hamilton County's high rates stand out because national data tend to underreport injuries from falls.

        Others say the injury data simply reflect the consequence of an aging population, perhaps concentrated in higher numbers in Hamilton County. And some wonder whether there's something about Cincinnati culture — or at least about senior lifestyles — reflected in the report.

        After retiring 16 years ago from Procter & Gamble, Mr. Ellenberger said he has no significant financial worries — but he's still a penny-pincher, sometimes to absurd levels.

        “I could afford to give $3,000 to Children's Hospital, but I hate to spend $25 to have someone clean out my gutters,” said Mr. Ellenberger, 76. “It used to be simple to climb a ladder and get that done. But now, I do that at the risk of my life.”

        Mr. Ellenberger says Greater Cincinnati is full of people like him, who place great pride in independent, frugal living.

        Such people insist on living in their own homes, doing their own yardwork and hauling their own laundry up and down the basement steps. They won't take help, especially paid help, even when they know they don't get around so well anymore.

        “Most guys know when they're doing something wrong. But they do it anyway,” Mr. Ellenberger said.

        Dr. Carl Parrott, Hamilton County coroner, said the fall injury report has some parallels to quick reports this year out of Cincinnati about high numbers of deaths from the summer heat.

        His theory: Fall-related deaths occur everywhere, but Hamilton County is more aggressive than many counties about counting them.

        For example, consider a hypothetical case of a previously mobile woman who dies less than a week after breaking her hip. A community doctor filling out a routine death certificate might list the cause of death as cardiac arrest, and the hip fracture might be listed among whatever other health problems were known at the time.

        In Hamilton County, people in local vital-records departments have been alerted to flag such cases and fax them to the coroner for investigation. As a result, many such deaths get properly counted as fall-related, Dr. Parrott said.

        “To me, what the local report shows isn't so much about whether we're so much higher than the rest of the country. It shows that injuries from falls are a bigger problem than many people think,” Dr. Parrott said.

        The problem, he said, is that falls by the elderly are taken for granted even though many, maybe even most, can be prevented.

        Hamilton County is forming a task force, to be headed by County Commissioner John Dowlin, to recommend ways to reduce fall-related injuries.

       



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