BY KENNETH O. BURRIS, JR.
The U.S. Fire Administration (USFA) launched the new nationwide Prevent Fire. Save Lives campaign at the Fire Department Instructors Conference in Indianapolis, Indiana. The campaign is the USFA’s first major public step toward a recently set goal of reducing the loss of life by 50 percent over 10 years in the “65-years-and-older” age group. The campaign works to empower at-risk group populations, educate the general public, and urge fire service organizations and groups working with older Americans to join together to take action to reduce fire deaths among this age group.
The campaign will disseminate TV, radio, and print PSAs, as well as fact sheets and other materials through the media, the USFA’s Web site, and partner organizations that want to help get the word out to their members and the general public. The following provides an overview of the level of risk fire presents to older Americans and, thus, the USFA’s rationale for this national program.
INCREASE IN OLDER AMERICANS
The elderly population in the United States, although currently growing at a moderate pace, will increase dramatically in the near future. Those who are ages 65 and older currently represent 12.5 percent of the total population and number 34 million, an all-time high. Over the past century, the number of persons over the age of 65 has tripled. Between now and the year 2050, the elderly population is expected to double, reaching 80 million, or 20 percent of the American population. Most of this growth is expected to occur between the years 2010 and 2030, when the Baby Boom generation will enter retirement. This group of 75 million people born between 1946 and 1964 currently constitutes nearly one-third of the entire U.S. population and will be entering their 60s during those decades. Over the course of these two decades, the elderly population is expected to grow by 2.8 percent annually, as opposed to 1.3 percent from 1990 to 2010 and 0.7 percent from 2030 to 2050.
Although the newly retired tend to live with relative ease and independence, nearly one out of every four Americans over the age of 85 resides in a nursing home. There are still other elderly who, although not institutionalized, rely on outside assistance to accomplish one or more daily functional activities. Furthermore, as the young adult population wanes, the pool of persons who can care for the elderly will shrink, making it increasingly difficult to provide resources to older adults that will enable them to lead productive lives.
THE AGING PROCESS ADDS TO FIRE RISK
Sensory impairment is a common complication of aging. The elderly tend to experience diminished visual acuity, depth perception, hearing, and sense of smell, as well as deficits in mobility and balance. Any one of these deficiencies can make an individual more vulnerable to the dangers of fires and burns. For example, the inability to smell smoke coupled with existing respiratory problems increases the likelihood of succumbing to toxic fumes and smoke inhalation. Older adults, however, often experience many, if not all, of these deficiencies simultaneously.
Older adults have a diminished sensation of pain, further contributing to a delay in treatment of serious burn injuries. It has been shown that the mortality from burns for individuals over the age of 65 increases fivefold when treatment is delayed from two to five hours. In addition, an older adult may be less aware of burns as a result of decreased perception of heat and sensitivity to pain. Coupled with chronic illnesses, weak bones, and slower reflexes, the elderly population is significantly more likely to incur accidental injuries and less likely to survive them.
Dementia and age-related neurological disorders can also increase an older adult’s likelihood of being injured in a fire. Alzheimer’s disease-a progressive, degenerative disease that attacks the brain and results in impaired memory, thinking, and behavior-affects one in 10 persons over 65 years of age and nearly half of those over 85. Because these conditions can cause individuals to experience an altered level of awareness, they may not recognize the danger presented by a fire.
It has been estimated that at least 10 percent of the elderly population suffers from depression. This psychiatric disorder substantially affects the social functioning and quality of life of older adults. A correlation between alcohol and smoking-both independent fire risks-in clinically depressed patients has been identified. The combined use of alcohol and drugs to combat depression can lead to even riskier behavior and increased fire risk.
The elderly also exhibit certain behaviors that place them at greater risk for having a fire. Many older adults rely on alternative heat sources, such as space heaters and electric blankets, because of poor internal thermo-regulatory mechanisms associated with aging. The use of a space heater increases the chances of a fire’s starting, especially if the unit is not maintained or operated properly. Repeated washing of electric blankets can compromise their wiring structure and create fire risks. An added complication is that many older adults live alone and are less likely to receive prompt help in fire emergencies.
ELDERLY FIRE CASUALTIES
Complications associated with aging increase the likelihood that an elderly person will accidentally start a fire and at the same time reduce the chances of surviving it. A significant factor behind this high risk of fire death among seniors is smoking. Smoking fires are the leading cause of fire deaths among the elderly. Approximately 15 percent of adults over age 65 use tobacco products. Additionally, medications that cause drowsiness and the use of alcohol increase the risk of starting a fire with a smoking material. Fires of this nature are particularly injurious, as the most commonly ignited material is the victim’s clothing or bedding-a situation that substantially reduces the victim’s ability to extinguish or escape a fire before being overcome. Heating and cooking fires are the second and third leading causes of fire-related deaths in older adults.
Unintentional injuries take the lives of approximately 30,000 elderly each year. Of those fatalities, fires and burns cause approximately 1,200 deaths per year. In comparison with the rest of the population, older adults have significantly higher fire death rates. The fire death rate for people over age 65 is 20 percent higher than the national average. For those over the age of 75, the rate is double the national average; for those over 85, the rate is four times the national average.
The elderly population has the highest risk of dying in a residential fire-where the majority of civilian casualties (fatalities and injuries) occur. The largest number of elderly fire fatalities (23 percent) occurs in victims over the age of 85, followed closely by those ages 75 to 79 (21 percent) and those ages 80 to 84 (19 percent). As the elderly population swells, especially among the most elderly, a corresponding increase in fire deaths among older adults is likely. As the nation’s elderly population grows, the fire death toll will likely rise in direct proportion to that growth unless measures are taken to ameliorate the risks associated with this group. The fire safety community must address the fire safety needs of older adults or be faced with the potential for a severe public health problem.
Positive behavioral change of targeted audiences such as the older population should be an integral part of a community’s fire safety education initiatives. The USFA, in conjunction with others, is committed to a measurable reduction in the fire morality rate of America’s elderly population. In addition to the Prevent Fire. Save Lives campaign, the USFA, in partnership with the AARP, offers a free booklet called “Fire Safety Checklist for Seniors,” which provides tips and suggestions on how to keep the home fire-safe. This booklet can be obtained by contacting USFA@HagerSharp.com. Additional materials are available by visiting the USFA Web site www.usfa.fema.gov.
KENNETH O. BURRIS, JR., is the chief operating officer of the U.S. Fire Administration. He retired as fire chief from the City of Marietta, Georgia. He has an MPA from Kennesaw State University and a bachelor’s degree in fire protection and safety engineering technology from the University of Cincinnati. He formerly served as treasurer of the International Association of Fire Chiefs.