Pedestrian slips, trips and falls

The UK has an ambitious target that 50% of journeys are walked or cycled by 2030. However, for some groups the quality of footpaths is a major deterrent to walking. According to a Living Streets report, 48% of older adults say they would walk more if footpaths were better maintained. Their fear of slips, trips and falls is enough to put them off. And there is a health cost for this – not just the falls, but the lack of incidental exercise.

The number of trips and falls due to poor footpath maintenance is difficult to establish due to lack of data. Living Streets has done their best to gather what information there is to find out the state of play.

Hospital admissions and insurance claims are two obvious sources of information, but even this is patchy.

Front cover of the trips and falls report showing a man walking on a footpath using two walking sticks.

Pedestrian falls happen to people of all ages, but as people age they are more likely to fall and to sustain an injury. As a consequence they are more likely to find themselves in institutional care.

One finding is that the number of hospital admissions from pedestrian falls was three times the number from pedestrian-vehicle crashes. So, if we had better data on pedestrian falls, it could change the priorities for road maintenance spending.

The Living Streets report uses 10 observational case studies to gather more information on footpaths and falls. In the UK vehicles are allowed to park over kerbs onto the footpath. This not only blocks the path of travel, it degrades the quality of the footpath. Local authorities had different ways for people to lodge complaints about footpath maintenance.

Can things be improved?

The bottom line is that budgets decide priorities, but whose budget? In the UK, falls cost the national health service more than $2.3b per year. This figure is set to rise as the population ages. However, the focus of this cost is falls indoors and unreported falls outdoors is still a problem. Using proxy figures, Living Streets estimates there could be more than one million outdoor falls among older adults each year.

The role of road strategies and plans

In the UK, the Highways Asset Management Plan allows for local authorities to claim they they taken reasonable care to make sure the road was not dangerous to pedestrians. Is this still valid in 2024? The focus on the cost to highways is not accounted for in the cost of hospital and social home-based care. Both these costs are borne by local authorities yet there is no connection between the two.

The title of the Living Streets report is Pedestrian Slips, Trips and Falls: An evaluation of their causes, impact, scale and cost. There are several suggestions on how matters can be improved. The three key ones are: Standardise data collection, Integrate costs of transport and health budgets, and Provide prompt treatment after a fall.

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