Impact of dizziness and obesity on the prevalence of falls and fall-related injuries

Quantify the relationships between dizziness, falls, and obesity among adults.Cross-sectional analysis of a national health survey.Adult respondents in the 2008 National Health Interview Survey balance module were analyzed. With demographic information, data for balance and dizziness problems, reported falls, injuries from falls, and body mass index were extracted. Associations between balance/dizziness problems and falls or injuries from falls were determined. The additional association between obesity and falls or fall-related injuries in the setting of a balance/dizziness problem was determined.Among 216.8 ± 3.5 million adult Americans, 24.2 ± 0.7 million reported dizziness in the past 12 months (11.1% ± 0.3%; mean age, 45.9 ± 0.2 years; 51.7% ± 0.5% female), 11.5% ± 0.3% had fallen in the prior 12 months, and 26.3% ± 0.4% were obese. Among individuals reporting dizziness, 34.3% ± 1.3% reported falls, whereas only 9.1% ± 0.3% of nondizzy individuals reported a fall (odds ratio [OR]: 5.1; P < .001). Among dizzy individuals who reported a fall, 45.8% ± 2.1% were injured by the fall versus 35.6% ± 1.4% nondizzy individuals who fell (OR: 1.5; P < .001). The addition of obesity to dizziness increased the odds of falling by 1.3 (95% confidence interval: 1.2-1.5; P < .001) but did not significantly increase the odds of fall-related injury (P = .110).Dizziness/balance problems are strongly associated with both an increased tendency to fall and increased injury rate from falls among adults. The addition of obesity to dizziness was associated with a higher rate of falling but was not associated with a significantly higher rate of fall-related injury. Balance problems in conjunction with obesity need to be targeted in fall-prevention efforts.2b

(Un)Healthy Immigrant Citizens

This research argues that immigrants’ political, social and economic incorporation experiences, which are embedded in individual life-course trajectories and heavily influenced by governmental policies, play an important role in producing diverse health outcomes among older U.S. foreign-born persons. Using data from the 2008–2010 American Community Surveys and 1998–2010 Integrated Health Interview Surveys, we demonstrate how naturalization, a key indicator of social and political inclusion, is related to functional health in midlife and older age. Consistent with the theoretical framework, we find that among those foreign-born who immigrated as children and young adults, naturalized citizens show better health at older ages compared to non-citizens, although this relationship is partly mediated by education. But among those older foreign-born who immigrated at middle and older ages, naturalized citizens report worse health compared to non-citizens. Moreover, this negative health selection into naturalization becomes stronger for those naturalizing after the 1996 Welfare Reform Act