When the home becomes a hazard: fall risks among older adults in Thailand’s coastal rural communities

OBJECTIVE: In Thailand, the incidence of falls is higher in rural areas compared to urban regions, primarily due to environmental factors. While studies have examined fall risk factors, few have investigated home environments in rural coastal areas and their impact on falls among older adults. This study sought to investigate the relationship between home environmental risk factors and falls among older adults living in coastal rural communities in Thailand, contributing to targeted fall prevention strategies. METHODS: This cross-sectional study enrolled a total of 60 older adults, aged between 60 and 93 years, residing in rural coastal communities of Surat Thani Province. Participants were required to be Thai nationals living in their own homes, able to communicate independently with researchers, and willing to provide informed consent. Demographic and home environmental data were collected through structured interviews and corroborated by on-site observations of each participant’s home environment. A fall was operationally defined as having experienced at least one falling incident during the past six months. Descriptive statistics were applied to summarize participants’ characteristics, while Chi-square and Fisher’s exact tests were utilized to examine the association between socioeconomic and environmental factors and fall variables. RESULTS: Within rural coastal communities, 17% (95% CI: 7.2%-26.1%) of older adults reported experiencing at least one fall during the preceding six months. Bivariate analyses were conducted to explore factors associated with fall occurrence. In these analyses, being unemployed was significantly associated with a higher prevalence of falls (p = 0.002), whereas having a mosquito net installed in the bedroom was associated with a reduced risk of falling (p = 0.031). CONCLUSION: Falls were relatively common among older adults living in rural coastal areas, and two such socioeconomic and environmental factors demonstrated significant associations with fall occurrence. These findings suggest that initiatives aimed at addressing unemployment-related vulnerabilities and promoting practical home environment modifications may be beneficial for reducing fall risk in these communities, although further research is required to confirm causal pathways and evaluate the effectiveness of such interventions.