1. Section Editor(s): Kennedy, Maureen Shawn MA, RN


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Each year, according to the Centers for Disease Control and Prevention (CDC), one in three Americans 65 years of age and older falls, and 30% of those falls cause injuries requiring medical treatment. Falls are the leading cause of injury-related deaths and nonfatal injuries in older adults. Traumatic brain injuries resulting from falls caused nearly 8,000 deaths and 56,000 hospitalizations in this population in 2005, according to a recent report from the CDC.


To assist nurses, other health practitioners, and community-based organizations, the CDC has developed two guides that can be downloaded or ordered from its Web site (see Preventing Falls: What Works, and Preventing Falls: How to Develop Community-Based Fall Prevention Programs for Older Adults. The first describes 14 scientifically tested and proven interventions; the second focuses on helping organizations implement fall prevention programs.


The CDC also recently released an initiative called Help Seniors Live Better, Longer: Prevent Brain Injury for older adults, their children, caregivers, and health care providers. Developed in collaboration with 26 organizations, including the Emergency Nurses Association and the Visiting Nurse Associations of America, it features easy-to-use English- and Spanish-language materials to help prevent, recognize, and respond to traumatic brain injury in patients 75 years of age and older. For more information and materials, visit



The number of underinsured Americans increased by 60%, from an estimated 16 million people in 2003 to 25 million in 2007, according to a report in the June 10 issue of Health Affairs. People were defined as "underinsured" if their out-of-pocket medical expenses amounted to 10% or more or their deductibles amounted to 5% or more of their income; in other words, their health insurance didn't adequately cover their medical expenses. The report was based on data from a sample of 2,616 people ages 19 to 64 who responded to the 2007 Biennial Health Insurance Survey sponsored by the Commonwealth Fund. Although people with incomes below the poverty level were more likely to be underinsured than those with higher incomes, underinsured rates tripled in people with an annual income of $40,000 to $59,999. About half the underinsured (45%) had difficulty paying their medical bills, and more than half (53%) went without medical care, including not filling prescriptions or seeing their physician when sick. The fact that health care costs are increasing faster than incomes is partly to blame, as is the fact that, on average, deductibles tripled between 2000 and 2007. When insurance reform is considered, the authors say, programs should be designed with affordable premiums for people with low and moderate incomes to prevent financial stress.