Spatial Clusters of Serious Falls Requiring Hospitalisation: Implications for Targeted Prevention Strategies

Falls as a major cause of home injury and the pandemic-fuelled trend of spending more time at home indicate a need for examining the current nature of serious fall injuries. We aimed to identify and describe clusters of fall injury in Sydney before and during the dramatic rise in the prevalence of working from/staying at home and describe individual and neighbourhood factors associated with such clusters.

An analysis of 8115 fall-related injuries requiring hospitalisation from 2018 to 2021 in a local health district in New South Wales, Australia, was conducted using SaTScan to identify statistically significant spatial clusters. The district was comprised of four local government areas (Areas A-D) which had varying socio-demographic characteristics. For each year, logistic regression was used to examine associations with individual and neighbourhood factors.

The presence of significant geographic hotspots of fall injury hospitalisation consistently appeared in the west of Area B and along its borders with the west of Area C and the east of Area A before and since the rise in working from/staying at home. These clusters correlated closely with older age and socio-economically disadvantaged areas.

Spatial clusters of fall injuries occurring in the home environment were consistent before and during the rise in working from/staying at home. Taking into consideration individual and neighbourhood-level factors associated with identified clusters, specifically older age and socio-economic disadvantage, will enable more nuanced strategies to boost the effectiveness of intervention programmes.

Fall injury incidence was consistent in the study periods suggesting little if any effect of the rise in working from/staying at home on falls at home. Additionally, the need for geographically targeted fall interventions is warranted for identified high risk areas characterised by older age and disadvantaged populations.