Unequal Ground: A Review of Socioeconomic Disparities in Falls

Abstract

Falls among older adults are a leading cause of injury and hospitalization, with socioeconomic status emerging as a significant but often underrecognized risk factor. This review examined 9 studies and 1 narrative review across multiple countries, revealing that lower socioeconomic status is associated with an increase in fall risk through potential pathways, such as limited access to safety modifications, poor nutrition, reduced health literacy, and social isolation. However, some studies presented context-dependent findings, suggesting that cultural and environmental factors may moderate socioeconomic status-fall associations. Emergency nurses are uniquely positioned to intervene early, given that the emergency department often serves as the first point of contact after a fall. By incorporating a social determinants of health screening, initiating referrals, and providing targeted education, emergency nurses can help prevent repeat falls and improve recovery outcomes. Integrating social determinants of health assessments into emergency care is needed for advancing equitable, patient-centered strategies that address both clinical and socioeconomic contributors to fall risk.

Keywords: Fall prevention; Fall risk; Falls; Older adults; Social determinants of health; Socioeconomic status.