Free falls from heights: a persistent urban problem.

In order to determine the significance and implications of falls from heights in the North Central Bronx Hospital (NCBH) patient population area, the records of 203 patients who fell from heights of 5 to 72 feet and who died or were admitted to NCBH over a five-year-period were reviewed. Demographic and clinical data were collected and analyzed for 192 of those patients. The findings show a male-to-female ratio of two to one, an age range of four months to 86 years, and a disproportionately high incidence of falls among minority group children.Seventy-six percent of patients had skeletal, 12 percent abdominal, and 10 percent skull fractures and cerebral edema. Twenty-two percent of juveniles (0 to 17 years) and 5 percent of adults had craniocerebral trauma. Thirty-one percent required surgery. Ten percent of the admitted patients had permanent disabilities. A trauma scoring system, the Injury Severity Score, correlated directly with height fallen. Overall mortality was 28 percent but only 6.6 percent in the juvenile group. Most of the falls were accidental (45 percent) or suicide attempts (22 percent).Although recognized as a health problem at least since 1965, falls from heights continue to be a cause of morbidity and mortality in urban people 20 years later. Renewed efforts at education and the passage and enforcement of public health laws are needed if their numbers are to be decreased.