1. The Fall Prevention Center of Excellence is supported by the Archstone Foundation Aging in the Community: Fall Prevention Outside of the Home Jon Pynoos, PhD Co-Director Caroline Cicero, MSW, MPL, Research Asst. Fall Prevention Center of Excellence Andrus Gerontology Center University of Southern California 90089-0191 www.stopfalls.org

2. The Fall Prevention Center of Excellence is supported by the Archstone Foundation Impact of Falls on Governments and Agencies Emergency Personnel get Called to Help Older People up when They Fall Injuries from Falls Cost Billions/Year in Medi-Cal and Medicare Expenditures Falls Result in Hundreds of Claims against Cities, Costing Local Governments Millions. When a Participant in an OAA-Funded Program Falls, Hours are Spent Managing the Resulting Care.

3. The Fall Prevention Center of Excellence is supported by the Archstone Foundation FALLS: Beyond the Individual and Beyond Aging in Place Older People who Age in Place Also Age in the Community at Large. The Aging in Community Paradigm, Recognizes Older Persons’ Interaction with the Environment, both in the Home and Outside.

4. The Fall Prevention Center of Excellence is supported by the Archstone Foundation Indoor or Outdoor? Frail Older Adults Fall More Often Inside Their Homes, Where Home Modifications can Help. However, Younger, More Active Seniors Fall More Often Outside the Home, and Often While Engaging in Physical and Leisure Activities such as Walking or Gardening (Li et al, 2006).

5. The Fall Prevention Center of Excellence is supported by the Archstone Foundation Location of Falls Source: National Health Interview Survey, 1997-1998 (Kochera, 2002)

6. The Fall Prevention Center of Excellence is supported by the Archstone Foundation Outdoor Falls Happen in Many Places: Front steps Sidewalks and Driveways Gardens and Yards Intersections and Crosswalks Parking Lots Public Spaces Recreational Trails Commercial Properties Loading on and off buses and trains Escalators

7. The Fall Prevention Center of Excellence is supported by the Archstone Foundation Design Features that Contribute to Falls in the Community Poorly Maintained Sidewalks Tree wells Poor Lighting Steps or Bumps Debris from Trees and Plants Crosswalks that Force People to Rush Lack of Handrails Poorly Marked Steps and Curbs

8. The Fall Prevention Center of Excellence is supported by the Archstone Foundation Simple Community Policies to Help Reduce Falls Mark Damaged Sidewalks with Paint Install Respite Benches Increase Street Crossing Signals Illuminate Sidewalks not only Streets Clear Debris from Trees and Plants Paint Speed Bumps and Car Stops

9. The Fall Prevention Center of Excellence is supported by the Archstone Foundation

10. Examine Neighborhoods at Night as Well as Day Time

11. The Fall Prevention Center of Excellence is supported by the Archstone Foundation Conduct a Walkability Audit in Your Community

12. The Fall Prevention Center of Excellence is supported by the Archstone Foundation What is a Walkability Audit? Purpose: To Identify Concerns for Pedestrians Related to the Safety, Access, and Comfort of the Walking Environment. Use: To Identify Potential Alternative Solutions (such as Engineering Treatments, Policy Changes, or Education and Enforcement Measures). Source: http://www.walkinginfo.org/problems/audits.cfm

13. The Fall Prevention Center of Excellence is supported by the Archstone Foundation Who Performs a Walkability Audit? A Local Community Group or Collaborative Partnership A Multidisciplinary Team of Trained Professionals, including Engineers, Planners, Transportation Researchers, Pedestrian and Bicycle Specialists. It is Important to Include Older Adults, Persons with Disabilities and Intergenerational Community Members

14. The Fall Prevention Center of Excellence is supported by the Archstone Foundation Neighborhood Walkability Survey The City of Citrus Heights, (87,017 pop.) in Sacramento County performed a Walkability Survey. Partners were a Community Group Called REACH—The Residents’ Empowerment Association of Citrus Heights and local Neighborhood Associations. Funding: Center for Civic Partnerships’ Healthy Cities and Communities Grant

15. The Fall Prevention Center of Excellence is supported by the Archstone Foundation 2 Parts to Citrus Heights Survey Initial Survey in which Participants Answer Questions about: Walking in the Neighborhood,Sidewalk Availability and Conditions, and Access to Services within Walking Distance

16. The Fall Prevention Center of Excellence is supported by the Archstone Foundation “Outdoor Survey”, Citrus Heights Participants Walked and Evaluated the Community Based on the Following: Traffic Speed and Volume Unsafe Street Crossings Lighting Night Safety Pedestrian Trails Sidewalk Conditions and Obstructions

17. The Fall Prevention Center of Excellence is supported by the Archstone Foundation Results of Citrus Heights Audit, Presented in February, 2008 Most Suggestions and Requests Related to the Control of Traffic, Clearing Obstructions on Sidewalks, and Installing More Sidewalks. Residents Pointed out Specific Streets, Intersections that Needed Improvements in Signage, Lighting, Speed Control, and Enforcement of Existing Laws.

18. The Fall Prevention Center of Excellence is supported by the Archstone Foundation What You Can Do: AAAs can Engage their Local Senior Centers and Related Community Organizations to Collaborate on Walkability Audits. Seek out Intergenerational Partnerships with Schools, Community Colleges, or Local Community Groups to Evaluate the Neighborhood’s Friendliness to People of all Ages and Abilities. ADVOCATE!. Inform and Educate Local Policymakers.

19. The Fall Prevention Center of Excellence is supported by the Archstone Foundation Resources 1.Citrus Heights Neighborhood Walkability Survey Report, Prepared by Marois Consulting and Research, Feb., 2008 2. AARP’s Livable Communities: An Evaluation Guide has a checklist on page 52. www.aarp.org/research/housing- mobility/indliving/d18311_communities.html

20. The Fall Prevention Center of Excellence is supported by the Archstone Foundation

21. Questions? Caroline Cicero, MSW, MPL, CPG Research Assistant Fall Prevention Center of Excellence University of Southern California 3715 McClintock Avenue Los Angeles, CA 90089-0191 cicero@usc.edu 213-740-1364