Falls Free® Initiative

Leading a nationwide effort to prevent falls

The Falls Free® Initiative is a national effort led by the National Council on Aging to address the growing public health issue of fall-related injuries and deaths in older adults.

The Falls Free® Initiative includes:

  • A National Action Plan
  • A National Coalition
  • State Coalitions on Falls Prevention Workgroup with 43 state members
  • Numerous advocacy, awareness, and educational initiatives
  • Community infrastructure building to reduce falls among the elderly

Why Focus on Falls?

Falls remain the leading cause of injury death for older Americans. Falls threaten seniors’ safety and independence and generate enormous economic and personal costs. CDC’s Injury Center monitors falls, fall-related injuries, and associated costs, reporting:

  • CDC reports the death rate from falls among older adults has increased by 42% from 2000 to 2006.
  • Over 21,700 older Americans die annually from injuries related to unintentional falls.
  • In 2012, over 2.4 million older adults were treated in emergency departments for falls; more than 722,000 or 30% of these patients had to be hospitalized (Centers for Disease Control and Prevention, 2014).
  • The total cost of fall injuries for older Americans was estimated to be $36.4 billion (in 2010 dollars). By 2020, the annual direct and indirect cost of fall injuries is expected to reach $54.9 billion.

In addition to pain and suffering, and the high cost of rehabilitation, falls with or without injury also carry a heavy quality of life impact. A growing number of older adults fear falling and, as a result, often self-limit activities and social engagements. Resulting limitations can result in further physical decline, depression, social isolation, and feelings of helplessness.

This potentially bleak future for aging Americans is not inevitable; evidence-based interventions that target individual risk factors for falling have been shown to reduce falls and promote falls self-efficacy.

National Action Plan

In March 2005, NCOA, in collaboration with the Archstone Foundation and Home Safety Council, released the landmark evidence-based National Action Plan to prevent falls and fall-related injuries in older adults.

The Plan was published as a consensus document resulting from a two-day summit of many of the nation’s leading experts in falls prevention. Evidence was used to map out what should be done to reduce the growing number of falls and fall-related injuries in older adults.

Summit attendees included 58 national organizations, professional associations, federal agencies, and individual researchers.

Falls Free® Coalition

At the time of the Plan’s release, there was insufficient funding to mount a national campaign to promote action on its 36 strategies. In recognition of participant enthusiasm for promoting this work, the Falls Free® Coalition was created as a loose-knit organization of summit attendees and their organizations, charged with working toward the progress of one or more of the strategies that resonated with their organizational missions. Since its inception, the coalition has grown to 70 organizational members.

Since 2005, the Plan and Falls Free® Coalition activities have been serving as resources and catalysts for action. The Plan has been used to support grant and research applications and funding of community-based falls prevention programs. It served as the guiding document for state and local falls prevention coalitions and as the basis of the Safety of Seniors Act of 2007, now PL 110-202.

In recognition of the growing momentum in falls prevention and the broad dissemination of the Plan, and with the support of the Archstone Foundation, NCOA set out to measure the Plan’s impact by assessing progress over each of the 36 strategies.

The full report, Making a Difference, assessed achievements to date, but more importantly identified gaps in progress that will assist NCOA and the Falls Free® Coalition to develop future initiatives. Although progress across the 36 strategies was uneven, several important contributions were noted.

The National Advisory Panel met in 2008 to consider the progress report, deliberate new opportunities, and make recommendations for next steps.

Coalition Workgroups

One significantly effective strategy has been the creation of three Falls Free® Coalition Workgroups convened to address specific strategies within the Plan. They include the following:

The Advocacy Workgroup is the longest serving. It was largely responsible for the passage of PL 110-202 and has been actively advocating for appropriate levels of funding for the law. It also is responsible for increasing the falls prevention funding level for the National Center for Injury Prevention and Control. The workgroup promoted the annual National Falls Prevention Awareness Day Proclamations from the U.S. Senate beginning in 2008. In 2013, 47 states and the District of Columbia hosted state-level Falls Prevention Awareness Days in September.

The Home Safety Workgroup, comprised of home safety and modification experts, conducted a national search of home safety programs and published Creative Practices in Home Safety Assessment and Modification Study in 2008.

The State Coalition Workgroup was established in fall 2006 and is comprised of coalition leaders from 42 states who are working together to promote effective state strategies to address falls. This workgroup helped NCOA develop an online resource for other states interested in building a statewide coalition to reduce falls and related injuries among older adults. This resource has been useful in promoting the development and sustainability of state coalitions. The State Coalitions Workgroup has two active committees:

Please visit our interactive map to find your State Falls Coalition.

Future Activities

Much of the Falls Free® Initiative’s recent work has focused on linking national coalition members with state and regional chapters to their state coalitions and helping states achieve sustainability through regulatory and policy change.

We continue to explore opportunities for leveraging this work, capitalizing on the momentum and bringing awareness to the issue. Future efforts will focus on making the case for investment in programs and services, promoting basic professional competencies in falls prevention, and bringing programs and services to communities across the country.

This ongoing work has been supported by the Archstone Foundation, Humana, the Centers for Disease Control/National Center for Injury Prevention and Control, and U.S. Administration on Aging. We also applaud the thousands of dedicated professionals, volunteers, and older adults who are working to address this growing public health issue, without whom there would be no Falls Free® Initiative.