Before you pass judgment on the tumble President Joe Biden took on onstage at the U.S. Air Force Academy graduation on Thursday, take note: Falls are the number one reason Floridians land in the emergency room for non-fatal injuries.

In the Sunshine State, it is not just senior citizens who are driving this trend.

Nearly 500,000 Floridians of every age visited hospital emergency departments for falls in 2021, more than any other source of non-fatal injuries, including car accidents and poisonings. Indeed, in 2021, the most recent year for which Florida Department of Health data is available, 75- to 84-year-olds made up the largest group of those injured by falls, but nearly 31,000 people in their 20s went to hospitals for falls, too. Lawn workers are falling while trimming trees. Roofers are falling while pressure cleaning. Seniors are falling in their condos. Shoppers are falling in the grocery aisles, and all kinds of people are falling in the shower.

Falls from ladders also play a role, something to consider during hurricane season when you hang shutter panels.

Nearly 100,000 ER visits from falls in 2021 were children under 15. They fall from monkey bars, out of trees, and off their bicycles, among other childhood activities.

“Kids have lower center of gravity, bigger heads, so they fall often,” said Candace Pineda, trauma administrative director for Memorial Regional Hospital and Joe DiMaggio Children’s Hospital in Hollywood.

‘In our younger population, falls outweigh your heart attacks and your strokes,” Pineda said. “Falls count for about 50% of all injuries. So falls is number one followed by motor vehicle/motorcycle crashes.”

Patients between 20 and 50 often come in to the ER because they hit their head during a fall and feel dizzy or nauseous.

“The vast majority of those injuries are benign and just mild concussions,” said Dr. Cory Harow, medical director of the ER at West Boca Medical Center.

Falls can cause fractures or broken bones, like wrists, arms and ankles. People are most often hospitalized from a fall because of a head injury or hip fracture.

Seniors tend to fall because balance declines with age, as does vision, and many are taking medications that cause dizziness.

For older American, falls can be life-threatening.

Older Americans are dying of falls at more than double the rate of 20 years ago, according to a 2020 study of 36,500 Americans age 65 and up published as a letter in the Journal of the American Medical Association.

“With older people, their reflexes are not as sharp so they are unable to protect themselves as quickly,” Harow said. “A fall that would be trivial in a 20-year-old can be a catastrophic hip fracture in a 70-year-old.”

Harow said the majority of head injuries in the older patients who arrive in the emergency room are from falls. Those head injuries can be particularly dangerous for anyone on blood thinners.

“What I have noticed is one of major causes of falls is seniors walking in the parking lot and trip over the cement blocks that signify where to park the car,” he said. “They shuffle their feet and go right over.”

Harow said nationally, about 25% of seniors who come to the ER with an injury from a fall get admitted, a significantly higher percentage than younger patients. He advises Florida seniors to be mindful of their surroundings, remove loose carpets and look down as they walk.

And, he adds, consider adding a grab bar in the shower: “Make sure the environment in your home is as safe as possible.”