Background on Environment & Policy
What are environment and policy strategies?
- Interventions help create healthy places and practices to support healthy community members.
- Environmental interventions are designed to modify structures and physical surroundings in ways that improve individuals’ access to resources and overall capacity to prevent injuries from falls that impact their own health or the health of those around them.
- Policy interventions are laws or regulations that are put in place to achieve a goal, including organizational policies or public policies at the local, state or national levels. Policies are an important way to focus on the social, economic, and environmental factors that enable environmental hazards (e.g., infants or children falling from windows, older adults slipping in the bathtub).
- Environment and policy interventions are intended to improve behaviors and environments in order to decrease injuries from falls. Environment and policy interventions can include:
- Policies that support environmental changes in public places, residential care facilities, housing units and private homes to reduce injury from falls (e.g., window guards, no skid mats, handrails).
- Policies that support changes in standards of care (e.g., required training on prevention of injuries from falls among staff working in institutions for older adults or health care providers, adequate health insurance coverage for recurrent falls).
- Environments that maintain safe equipment (e.g., playgrounds) or provide materials necessary (e.g., free window guards, hip protectors) to reduce injury from falls.
Why are environment and policy strategies useful?
- They have the potential to reach all community members and create community changes that last much longer than most other types of interventions. It is believed that environments and policies changes are critical to creating broad-based changes in injuries from falls through modifications in behaviors and environments.
- Environment and policy interventions focus on preventing injuries from falls among children, older adults, or employees.
How can I use environments and policies in my injury from falls intervention?
- Interventions to prevent injury from falls among children: These interventions work to prevent injury from falls among children at a variety of ages. For the infants and toddlers, there have been interventions to decrease use of infant walkers, increase use of safety gates, or fix furniture to keep it from tipping over in order to prevent falls. For older children, interventions have focused on reducing falls from windows through the placement of window guards. In addition, interventions have focused on a number of activity related behaviors such as bicycle safety, water safety, and playground safety.
- Interventions to prevent injury from falls among older adults: These interventions work to prevent injury from falls among older adults, particularly those with cognitive, visual, or other physical impairments that place them at high risk for falling. These interventions have included assessment of public places and individual living spaces. Following these assessments, a variety of changes may be made to the environment including: smoothing surface of walking paths, adding handrails to walkways or stairways, rearranging furniture, improving walking surfaces (e.g., removing loose carpets or slippery tiles), repairing stairs, providing grab bars, improving lighting, and providing bathtub handrails or floor mats. These interventions may also involve providing individuals with proper footwear (e.g., new shoes, non-slip socks, or shoe additions such as coils or spikes to reduce slipping), equipment to improve walking (e.g., walkers), or access to places to be physically active.
- Interventions to reduce injury from falls among employees: These interventions have focused on advocating for policies and environmental changes to improve worksite safety. Such interventions may focus on changing Occupational Health and Safety Administration policies or enforcing existing policies. Alternately, some interventions have provided personal protective equipment, such as belts to keep the individual from falling. These interventions may be particularly important for construction workers, firefighters, and mail carriers who are at greater risk for falling while working.
With whom should I work to develop and implement environment and policy strategies in my injury from falls intervention?
- In order to create policies and environments that prevent injuries from falls in your organization, you may need to work with management and decision-makers to decide what makes sense for the organization (e.g., changes to worksites, changes to residential facilities for older adults, changes to walkways).
- In the community, you may want to meet with local organizations (e.g., educational institutions, community organizations) to decide what can be implemented as well as policy- and decision-makers to develop, enforce, and evaluate these policies and changes to the environment.
- It is also critical to work with local businesses that can help to implement these interventions (e.g., pharmacies, restaurant and grocery store owners and managers, food manufacturers and producers).
- You might consider working with experts in public policy, law, advocacy, law enforcement, community organizing, insurance or other partners to decide what changes can be made to improve the community as well as how these changes can be promoted.
How can I enhance environment and policy strategies in my injury from falls intervention?
- Intervention strategies such as group education and campaigns and promotions are often used in conjunction with environment and policy interventions. These strategies can be used to provide information to local businesses, health care facilities, senior centers, and day care centers to encourage and enforce the desired policies and related communication to let others know about the environmental changes and or polices (e.g., newspaper, radio and television ads).