Imagine an epidemic that permanently disables 100,000 Americans a year and costs millions of dollars in hospital costs each year.
Now imagine a potential antidote that anyone can buy at department stores or K mart. And no prescription is needed.
The epidemic is falls that result in hip fractures among those over 65. Approximately half the 200,000 seniors who suffer broken hips each year end up in nursing homes. And it's a safe bet that not one wanted to.
So imagine the response recently when a woman named Barbara Inglin appeared at the spacious, modern Senior Center in Renton, Wash., a suburb of Seattle, to tell the lunch crowd how to avoid damaging falls.
Ms. Inglin is coordinator for the pioneering Fall Prevention Program sponsored by the Injury Prevention Research Center at Harborview Hospital in Seattle. They're the same folks who helped reduce the number of head injuries by persuading bicyclists to wear helmets.
Now they're out to convince senior citizens that they can prevent not all falls, but the kind of debilitating sideways tumbles that result in life-threatening hip fractures.
"What causes falls?" Ms. Inglin asked the Renton crowd. "The No. 1 thing is unsafe shoes." So the Harborview program's message is that prevention can be as simple as buying safe ones.
As she explained, falls can be the result of drug side effects, impaired vision (and the use of bifocals), deteriorating balance and lack of muscular strength.
But the most common cause, she said, is "unsafe shoes," especially sandals, slippers, high heels and even loafers, "because they're not fastened to the feet, and come off if you fall."
Also found to be unsafe were shoes with slick soles or those with rubber bottoms that caught on walking surfaces.
According to a study done by the Harborview researchers, most serious tumbles happen in or near the home, commonly in bathrooms, on stairs, on wet floors, while moving on or off the curb or navigating frosty grass.
Those over age 75 are most at risk of serious injury, especially those who have not exercised to maintain strength and flexibility. As a result they lack the agility to catch themselves before they end up on the floor.
Other studies have suggested that hip fractures can be prevented by exercising or modifying the diet to prevent osteoporosis. While those methods can work, Ms. Inglin believes that wearing safe shoes is a simpler, less costly or time consuming way to attack the problem.
Indeed, Harborview's research estimates that up to 83 percent of hip fractures can be prevented if people would wear safe shoes.
So what qualifies as safe?
* Shoes that fasten firmly to the feet, with the fabric or leather surrounding the foot for adequate support.
* Nonskid soles.
* Styles that provide enough room so the toes can lay flat and straight.
* Athletic shoes, oxfords and walking shoes with non-slip soles are all good choices, Ms. Inglin said.
"It's more the characteristics of the shoe than the brand of shoe," Inglin told the Renton seniors. "They don't have to be expensive."