On January 1 1999 the USA switched from ICD-9 to ICD-10 for reporting mortality. (ICD-10 was not used for non-fatal clinical coding until 2015.) And as with all new things, morticians likely stuck with the more generic codes from ICD-9 and gradually started using some of the more specific iCD-10 codes over time. ICD-10 has 55,000 different codes compared to 17,000 codes available in ICD-9.

Could the gradual adoption of a more granular coding system in 1999 explain the increase in reported deaths due to falling that starts in 2000?

I guess the hypothesis makes sense. They say it's probably Drugs, Alcohol, Obesity and Fourth, some of the increase may be due to changes in reporting. As people have become more aware of the danger of falls, falls that used to not be recorded as a cause of death may increasingly be reported as a cause.

Aside from alcohol and obesity, I don't see: 1. Cancer survivability. If people aren't dying from cancer they will be more likely to die from a fall in a weakened state. 2. Two level homes are a higher percentage of new construction and people are more able to afford it when they're older.

Edit: okay they did mention fewer deaths from other causes such as cancer and heart disease.

> Second, some of the increased deaths may be due to rising alcohol consumption. According to data from the National Survey of Drug Use and Health (NSDUH), the percentage of people aged 65 or older who consume alcohol each month increased by 16% between 2002 and 2019. From 2002–2003 to 2021–2023, the share of this group who reported binge drinking in the past 30 days rose from 7.3% to 11.4%

I've been hearing nothing but the complete opposite, that people are drinking less than ever

https://news.gallup.com/poll/693362/drinking-rate-new-low-al...

> Americans' drinking habits are shifting amid the medical world’s reappraisal of alcohol’s health effects. After decades of relative steadiness in the proportion of U.S. adults who drink, Gallup has documented three consecutive years of decline in the U.S. drinking rate as research supporting the “no amount of alcohol is safe” message mounts. Compounding the challenge for companies that sell alcohol, drinkers now appear to be dialing back how much they drink, as well.

How are they finding completely opposite trends?

I'll throw this out. Due to inflation and cheaper goods (Baumol effect) more people are engaged in activities which can lead to accidental falls - DIY projects like cleaning gutters.

> Third, it may be due to increased rates of obesity. A CDC study found that obesity increased the propensity for someone to fall in a laboratory setting. And obesity rates among people 60 and older rose from about 32.8% in 2001-2002 to 38.5% in recent years.

It's not just the chance of falling itself that warrants a look. More weight also means more energy dissipated.

On top of that, the problems with falls start to get really serious once fractures get into play [1].

What I can't find any data on is a change of floor material compositions. Anecdotally, I remember many of my older relatives having really soft carpets in their homes, while in more modern homes and even care institutions you will find hard material - hard carpet, wood, tiles or in institutions, straight concrete. All of these have the advantage that you can keep them clean and hygienic with far less effort - but damn, even as a younger person it hurts much more tripping over my cat when in areas with hard flooring. And they're slippery when wet!

For an older or obeser person, it sounds at least plausible that the flooring material contributes to more severe (and, consequentially, more fatal) fall events.

[1] https://www.rechtsdepesche.de/hohe-sterblichkeit-nach-gefaeh...

I would assume it is because of the extra distractions now. Everything becoming "smarter" and more addictive. How many were looking at their phones, hurrying back to catch the increasingly manipulative "news", or frustrated because their voice assistant didn't understand them?

Since 2000 all of these things, and the amount of tech per household in general, have gone up quite a bit. I'm surprised it wasn't listed as a hypothesis worth looking at.

It is weird that the graphed increase grows steadily at presumably the same rate - there is no spike or bump or curve. I wonder if that indicates anything. Disregarding the shape of the graph, I would have guessed at a change in reporting instead. The steadily rising curve almost looks like something being gradually employed. At some point, the curve ought to change direction, if not before, then after the last person has fallen over.

As a side note, I've gotten my dad into dirtbiking for the first time at 65.

He has padded shorts, and padding pants, and a padded shirt. He then wears my track leathers, even though he's on dirt. He's fallen a few times and he agrees you feel like superman.

He's started joking that if he makes it to 75, he's going to start wearing the padded shorts and shirt as regular daily wear.

Would be interested to see a breakdown of what type of falls these are. Falls in bathrooms, outside or on ice?

From sad experience with my own family - I'd also consider declining quality of treatment. Patients who fell may be neither cool nor lucrative for the medical-industrial complex. Also said complex protecting its own, by attributing some "oops, we goofed" deaths to falls.

If I had to guess it would be people getting heavier, weaker, and more sedentary than the past.. making falls more likely.

Also people seem to like hard flooring lately instead of carpet. Even backyards are getting more cemented by the decade.

I didn’t see this discussing whether falls have become more dangerous. How much of this is because the elderly fall more often and how much because, if they fall, they’re more likely to die?

If the latter, it seems the elderly have gotten worse at falling, possibly because they fall less at young age, and aren’t as good in breaking their fall as before.

And yes, it will be difficult to gather data on ”fell with little consequences”, but for the elderly, many falls will lead to doctor visits, so there likely is data on that.

everyone be trippin'

If you are sharing facts like "Wisconsin falls are more deadly than Alabama falls", then you need to address the more obvious hypotheses that are conjured in the readers head. I found no mention of "ice" or "slippery", and instead the article blazed forward with its preferred explanation without providing evidence to dismiss the more obvious hypotheses.

Could less physical labor lead to weaker bones or atrophied muscles leading to greater fall mortality?

I did an Ozempic stint and noticed my bone density had decreased to the bottom 3 percentile for my age, and I lost muscle as well.

It's all on me, of course, but I wonder if this phenomenon is widespread, and if it'll result in more deaths from falls.

maybe because we now walk around with phones in our hands looking at screens. So when falling, we’re less prepared?

I’m surprised they didn’t mention increased social isolation.

This might be evidence that the gravitational constant G is changing (increasing) over time! Could this be the explanation for dark matter and dark energy?

People look on their smartphones too much. They don't even look where they are walking anymore.

Those two maps don't agree about Idaho.

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Very old people are a larger proportion of the total population than before.

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Distraction by phones? (E.g. falls while taking deliberately dangerous selfie.)

Now graph this against the rise of mobile devices…

E-bikes?

Idiocy?

Lots of new pastimes involve climbing up, diving off, or jumping between very tall things.

Usually with some sort of recording/streaming device strapped to the hobbyist.

People fall because the surroundings are unfamiliar, their trust and assumptions about things around them, and about themselves, have gone wrong. Why does this discrepancy arise? For older people, the world around them and food they eat has changed too fast, to the extent of being an alien land. They walk on a surface, making assumptions based on what they were familiar with in the past. But the surface is no longer the same. They eat the changed food, assuming that it will keep them as strong as before. That turns out to be false as well. Most old people feel that they are living in a world that is completely unfamiliar and untrustworthy.