Thursday, September 15, 2005

AARP, accidents, acculturation


accidents - Although accidents rank behind a number of other leading causes of death among the elderly, they are of special concern because they represent the most avoidable of all killers. Older people are more likely than the young to make a poor recovery and to experience complications from an accidental injury, with correspondingly higher health-care costs as well as disability and death. Among teenagers and youths the death rate from accidents is high (64 per 100,000 people) because they tend to take more risks in such things as sports, high speed driving, and motorcycling. At age 65-74, long after the risk-taking behavior of young people has passed, the death rate from accidents is slightly lower (61 per 100,000), but after age 75 it increases nearly three times (166 per 100,000).
For 15- to 24-year-olds motor vehicle accidents rank first as a cause of accidental death (46 per 100,000), and they also rank first, though at a much lower level, for people age 65-74 (22 per 100,000). After age 75, falls become the main cause of accidental death (86 per 100,000), while automobile deaths stand at 30 per 100,000. As these figures show, the death rate from automobile accidents is greater after age 75 than at age 65-74, but this is due in part to the greater frailty of the 75 age group. With respect to pedestrian deaths due to motor vehicles, older people rarely die from this cause (in a recent year about 2,000 such deaths occurred among the several million people who died over age 65), but experts observe that traffic lights may change too quickly to allow the old enough time to cross streets and intersections in safety.
In accidental injuries that occur when people are at work, the statistics run contrary to what one might expect- older people have a much lower accident rate at work than most younger age groups. At 65 there is a 0.41 injury rate compared to 1.38 at 20- 24, 1.15 at 25-34, 0.89 at 35-44, and 0.77 at 45-64. These ratios are work-injury ratios and are derived by dividing the percentage of all work injuries experienced by an age group by the percentage of all workers represented by that age group. For example, persons age 65 and over represent 2.2% of
all workers but account for only .9% of all injuries, or .9% 2.2%=0.41. Home accidents, however, occur more often to people over 65 (falls, bums, fires that result in injury, ingesting food poorly, poisoning by liquids, or asphyxiation by gas). The older age group also experiences more accidents while in hospitals and nursing homes, when, because of weakness or lack of experience, they fall getting in or out of wheelchairs and when using the bathroom.
Snow, ice, and areas with rough or rocky ground also cause problems, as do dropping of cigarettes, neglect of cooking devices, and misuse of
drugs or medicines.
Sterns, H. L.; Barrett, G. V.; and Alexander, R. A. "Accidents and the Aging Individual," in Birren, J. E., and Schaie, K. W., Handbook of the Psychology of Aging (2nd ed.). New York: Van Nostrand Reinhold, 1985.

acculturation - The process of the rapid cultural change that occurs when two different cultures are brought into contact is known as acculturation. Studies confirm that cultural variables are important in inducing biological changes that contribute to HYPERTENSION and coronary heart disease. Three acculturation indices were used in a study of Japanese-Americans: (1) culture of upbringing; (2) culture assimilation (the degree to which new customs, language and diets were accepted); and (3) social assimilation (the degree to which contacts were made outside the Japanese community). Those who were most acculturated to Western culture had three to five times higher prevalence of coronary heart disease.
In the tribes of the Solomon Islands, those who were most Westernized had higher blood pressure, higher cholesterol levels, and higher stress levels than those tribes maintaining the traditional tribal lifestyle. Researchers conclude that repeated stressful situations, as can be found in adapting to a new culture, have a negative effect on the aging process. They emphasize the importance of a stable society whose members can enjoy support in a closely knit environment as the best protection against the various forms of social stress.
Marmot, M. G., and Syme, S. L. "Acculturation and Coronary Heart Disease in Americans." Amer. J. of Epidermology 104: 225-247 (1976).
Page, L. B. et al. "Antecedents of Cardiovascular Disease in Six Solomon Islands Societies." Circulation 49: 1132-1146 (1974).


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