Falls kill more people than guns or cars, but we can reduce the risk.

I have written often about falls and how they kill more people than guns or cars, but nobody wants to talk about it. I usually write about how it is a problem of dangerous design:

This isn’t just a problem of people being old and frail; it’s a design problem. It’s an interior design problem, a building design problem, an urban design problem, a maintenance problem, and an attitude problem of blaming the victim. As the population ages, the problems and the costs will only get worse.

I have cited research suggesting that 40% to 60% of falls are due to what I call dangerous design, but there are things we can do to reduce the risk and the damage.

We can’t do much about getting old, but Dr Howard Luks points to new research stressing the importance of muscle strength. The study of older Norwegian men and women found “greater muscular strength was associated with a lower risk of severe fall injuries.”

The study followed 3,000 adults over 80 years old, testing their handgrip strength and how quickly they could stand up from a chair five times. Luks summarises the results, noting that people classified as having strong leg strength had about a 40% lower adjusted risk of a serious fall injury. Luks notes:

“Getting out of a chair requires leg strength, coordination, balance, and enough power to move your body against gravity. In other words, the ability to stand quickly from a chair is capturing more than muscle strength alone. Those are precisely the abilities we need when we stumble, step off a curb awkwardly, or need to recover quickly before a loss of balance becomes a fall.”

The study explains:

“Increased muscle strength may protect against more severe fall injuries, potentially by enhancing protective mechanisms during falls, such as rapid upper-limb reactions, reaching for support, and using the arms to attenuate impact.”

Luks concludes:

“If you want to kick ass in your 80s, you had better be kicking ass in your 50s and beyond. The biology of aging and the rules that govern training and adaptation change as we age— and not in our favor.”

I have been going to the gym and have been doing my best to improve my leg strength, balance, and coordination, but I have previously quoted Howard Luks: “We don’t need more gyms — we need more opportunities to move. We can design cities, homes, and workplaces that invite movement rather than discourage it.” Luks makes a good list:

• Stairs that are visible, wide, and beautiful — not hidden behind emergency doors.

• Bike lanes and walking paths make active transport the most logical, pleasant option.

• Public spaces with benches you have to walk to, green areas you want to cross, and communities that reward being outdoors.

• Offices that prioritize standing meetings, walking breaks, and natural light.

• Neighborhoods where errands can be done on foot.

But if we are going to use those stairs, public spaces, and walking paths, we'll need the strength, coordination, and balance to handle them. I have found the gym helps with that.

The gym is particularly useful in the USA, where most people do not live in walkable communities, and the Department of Transportation is no longer supporting"DEI bike lanes," with a spokesperson saying,

"Since nearly 80% of the population uses cars to get to work and their important medical appointments, we are taking a closer look at federal guidance to ensure American families have the infrastructure they need. This is a common sense approach despite the Left's belief that everyone should ride a bike to their shoebox-sized apartment to eat crickets to achieve a phony climate agenda."

Or as Beth Osborne translated,

“Since we have forced people to get everywhere by car through government regulation that requires all your needs to be built far away and connected by roads that will kill you if you get out of your car, we are going to use the obvious result (forced driving) as a reason to double down.”

That’s the problem. I am a big fan of Dr Luks’ urban design prescription, but most Americans who follow his exercise prescription probably drive to the gym. Perhaps someday Secretary Duffy will get out of his RV and recognise that his voters are getting older, they can’t all drive, and they want to walk and bike to stay fit and healthy.