Google Street View a quick way to assess fall risk - NZ researchers
New Zealand university researchers have come up with a novel use of Google’s free Street View service to analyse public roads and footpaths for their risk of causing falls.
The researchers from the University of Otago, the University of Auckland, and AUT used Google Street View which had its roots in a Harvard University project and debuted as a Google service in 2007, used it to look at over 2,000 sites, including GPS locations, where St John ambulances attended outdoor falls.
They then answered numerous key questions covering factors like kerb type, footpath material and obstructions in a survey they had designed about the footpaths and roads, typically completing each virtual site survey in less than five minutes. They found that over 60% of fall sites have at least one trip hazard due to poorly maintained footpaths. They noted that they didn’t look at areas where falls didn’t occur, so can’t draw a link between trip hazards and the risk of falling.
Falls are a leading cause of injury and accidental death among older adults. Around one-third of older adults fall each year in any context, according to sources cited by the researchers. One-third to half of all falls are pedestrian falls, defined as those occurring on the road or footpath.
“Falls outside the home are particularly important because falling, and a fear of falling, can prompt older individuals to restrict their activities outside the home which can further affect quality of life.” the authors write in New Zealand Population Review.
Poor quality footpaths can be identified by community groups using Street View.
Source: New Zealand Population Review
Going virtual
But the authors say that community groups and researchers could easily and cheaply use Google Street View with the series of questions they have designed, to audit areas that may pose fall risks. Such use could avoid the need for more time-consuming physical site visits.
The virtual Fall-SAFE (Fall-Systematic Audit of Environment) tool is primarily aimed at identifying fall risk for older adults. Based on the thousands of reported falls the researchers examined, they found that most falls occurred in residential or commercial locations on flat or gentle slopes.
Footpaths were largely present on both sides of the road and 61% of fall locations had one or more trip hazards from poorly maintained sections of the footpath. Only 5.8% of sites had no obstructions. By using tools like Fall-SAFE, authorities can systematically assess and identify environmental risk factors for falls, such as uneven surfaces, obstructions, or poor lighting.
Google Street View’s historical imagery feature, accessible by clicking on the “See more dates” blurb in the Street View app, enables comparisons of street environments over time, helping to evaluate the effectiveness of interventions aimed at reducing fall risk.
The researchers say that community groups or advocates to demonstrate to local government the need for improved pedestrian infrastructure, potentially leading to safer environments for older adults.
High resolution imagery makes Street View a useful tool, but it has its limitations.
Street View has its limits
The researchers admit that virtual audits using tools like Street View have their drawbacks.
“For example, image quality can be poor, image data collection protocols are ambiguous, and it can be difficult to identify small or temporary features,” they write.
But cost-pressure is making virtual audits a necessity.
“Drop-and-spin audits are conducted at a single point and have clear time and resource benefits when compared with traditional segment-based audit protocols which traverse a short length of road,” they continue.
So how accurate is Fall-SAFE? The researchers report that most items (65%) in the Fall-SAFE tool showed substantial to almost perfect reliability according to observers, while 84% of items had at least moderate reliability.
Ultimately, Fall-SAFE showed "moderate capacity to predict falls” and the authors note that it “fills a gap between short screening tools and longer assessment tools, suggesting it provides a balance of efficiency and predictive ability”.
“The Fall-SAFE tool is a reliable virtual audit tool developed specifically to assess the street environment from a falls-risk perspective,” they add.
This isn’t the first time that New Zealand researchers have drawn on Google Street View for public health-related information gathering. One small study found that Street View was “efficient” for identifying smokefree signage at school grounds in NZ.
In Japan, researchers have analysed built environments via Street View to help residents of areas at risk for natural disasters learn how to get out of the area. Studies in New Zealand, Spain and Belgium have also drawn on Street View to study cycling infrastructure.
