Zones of prevention: the geography of fall injuries in the elderly

Our investigation of the geography of fall injuries considers the relationship between injury prevention and contextual approaches to health research. We use a geographic information system (GIS) to describe the pattern of emergency department reported falls of the elderly in the Capital Health Region, an administrative health area in Alberta, Canada. We used empirical Bayes estimates to obtain a geographic measure of fall incidence over the study area and a cluster detection statistic to measure the presence of a significant spatial cluster in the region. Inner-city Edmonton had the highest incidence of risk, suburban Edmonton the lowest, and surrounding rural regions and smaller communities had more moderate fall incidence. We argue that descriptive geography can enhance the effectiveness of injury prevention programs by identifying zones of high risk, even when the individual-level and contextual factors that explain the underlying patterns are unknown.