PP1414 - Risk of Falls in Underserved Populations: A Scoping Review

Abstract:
Health disparities are preventable differences in the burden of disease that are experienced by socially disadvantaged populations including people of color. By 2060, 50% of the U.S. will include Hispanic and African American people. A scoping review of current research examining health disparities and falls risk was completed. Findings show most falls risk research is on disproportionate non-Hispanic white individuals. Studies that include minority participants show mixed results with some reporting higher falls risk in minorities and others showing the opposite. Future research will be discussed including the role of audiology in reducing falls risk in underserved populations.

Summary:
The U.S. population is aging rapidly, with one in five Americans projected to be aged 65 or older by 2030 and age alone is an independent risk factor for falling. Health disparities are preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health. These disparities are influenced by factors like socioeconomic status, education, and demographics. By 2060, more than 50% of the U.S. population will consist of people of color, including Hispanics and African Americans, emphasizing the need to address health disparities and falls risk in minority populations. Addressing these disparities requires understanding their underlying mechanisms and examining current assessments and interventions.

This study aims to examine disparities in preventive care related to falls risk through a scoping review of the current literature. We focused on systematically finding studies that assess current falls prevention efforts for diverse populations. Using the PRISMA guidelines, three databases were initially searched with terms like “falls risk,” “health prevention,” “health disparit*,” combined with “audiology” or “hearing science.” When this search yielded no results, “audiology” and “hearing science” were omitted, yielding 255 articles. After removing duplicate articles, abstract screenings, and full text reviews, twelve original articles met our inclusion criteria.

The studies varied in methodology and the communities surveyed. Four of the twelve studies employed the CDC’s STEADI initiative to assess fall risk; however, few studies offered standardized interventions after identifying individuals at risk for falls. Two studies focused specifically on Indigenous tribes, highlighting the unique challenges of accessing healthcare in remote locations and underscoring the critical importance of falls risk prevention for these communities. These studies adapted the CDC’s Stay Independent program to provide culturally appropriate interventions for these communities. As a result, the literature was divided: three studies reported higher falls risk among minorities compared to non-Hispanic white Americans, while another three found that white Americans were at greater risk of falls than individuals from racial minority backgrounds.

Despite the differences between studies, a recurrent theme was the role of social factors, such as education level and fear of falling, in influencing an individual's risk of falls. This insight will prove to be crucial as further research is warranted to examine the prevalence of falls risk in underserved populations and for the creation of culturally appropriate interventions.

As previously noted, no empirical studies currently address falls risk prevention in underserved populations within audiology, despite this topic being found in other research areas. Integrating audiology into falls prevention initiatives is essential, as hearing health is a critical factor in maintaining balance. Research shows that at least 20% of patients presenting with vertigo have BPPV (benign paroxysmal positional vertigo), a condition managed within audiology and the most common cause of peripheral vertigo. Including audiology in falls prevention strategies can strengthen intervention approaches for both underserved populations and the general population. Future research and healthcare initiatives should consider audiology as part of a comprehensive strategy to reduce falls risk, especially in aging and diverse communities.

Intermediate level, emphasis placed on new knowledge.