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Aug 1

Older Adults and Adults with Disabilities: Federal Programs Provide Support for Preventing Falls, but Program Reach is Limited – Government…

What GAO Found

Nine federal programs are designed to help prevent falls or improve accessibility for older adults or adults with disabilities by providing evidence-based falls prevention (e.g., exercise classes), home assessments (e.g., home safety checklists), or home modifications (e.g., railings or ramps). Four agencies oversee these programs: Administration on Community Living (ACL), Centers for Disease Control and Prevention (CDC), the Department of Housing and Urban Development, and the Department of Veterans Affairs. These programs serve limited numbers of individuals, based on agency survey responses. Officials from national stakeholder organizations GAO spoke with said that not all populations at risk of falls may be served, including adults with disabilities under age 60. GAO's analysis of national data on self-reported falls from 2020 found that adults with disabilities aged 45 to 59 reported rates of falls and fall-related injuries that were higher than those reported by individuals 60 and over. However, because CDC's analysis of these data has focused solely on older adults, federal agencies may be limited in their understanding of the range of groups at risk.

Estimated Percentage of Reported Falls and Fall-Related Injuries by Age and Disability Status, 2020

Federal agencies have conducted various health-related studies of three of the nine federal programs. These studies suggest positive health outcomes for older participants. For example, a study of older adults participating in one of ACL's programs, which included exercise and other evidence-based falls prevention interventions, found some experienced fewer falls and fall-related injuries.

Federal agencies administering the nine programs have coordinated to some degree and disseminated falls prevention resources to consumers. But they lack a way to sustain information sharing and reach all groups at risk of falls with relevant resources. ACL was created, in part, to help manage fragmentation among federal programs that help people who are aging or have disabilities live independently. However, it has not identified a mechanism to sustain efforts to share falls prevention and home modification information among agencies. Further, most federally sponsored consumer resources on these topics target older adults. ACL has not used its existing network of disability organizations and providers to share information on the risk of falls or falls prevention for adults with disabilities under age 60. Yet GAO's analysis found they are also at high risk of falls. By facilitating information sharing across federal programs and among its own disability network, ACL could better help all groups at risk of falls to safely age and live in their homes and communities.

Studies report that each year, about one in four older adultsmany of whom may also have a disabilitysuffers a fall. According to CDC, falls were the leading cause of death from unintentional injury among older adults in 2020. They cost billions of dollars in medical expenses. However, studies also show that assessing and modifying the home environment or using other interventions can help prevent falls.

This report examines (1) what federal programs are designed to provide evidence-based falls prevention, home assessments, or home modifications for older adults and adults with disabilities and what do national data indicate about those at greatest risk of falls, (2) what do federal agencies know about how these programs affect participants' health, and (3) to what extent do federal agencies coordinate their efforts and provide consumer information to those at risk of falls. GAO analyzed CDC falls data from 2020, the most recent data available, and surveyed relevant federal programs. GAO interviewed officials from national aging and disability organizations; and reviewed studies of federal programs, falls prevention resources, and relevant federal laws and regulations.

Older Adults and Adults with Disabilities: Federal Programs Provide Support for Preventing Falls, but Program Reach is Limited - Government...

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