Ageism as an Upstream Determinant: A Three-Level Framework for Reframing Fall Prevention.

Falls among older adults remain a major public health issue despite strong evidence supporting prevention strategies. Rising mortality and costs highlight a gap between knowledge and implementation. This gap is partly driven by ageism, which operates at structural, interpersonal, and individual levels, influencing how fall prevention is implemented, received, and adopted. Factors such as underreporting, environmental barriers, and internalized stigma reduce effectiveness. The article argues for a holistic, multilevel approach that integrates social determinants of health, especially ageism. Using frameworks like Reframing Aging, it recommends systemic, clinical, and communication changes to improve prevention, engagement, and safe mobility for older adults.