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Nobody knows why, but New Mexicans die from falling at a much higher rate than most of the rest of the nation.

Statistics that show New Mexico has the second highest rate of falling deaths in the nation, with a rate about twice as high as the national average, are striking, said Mike Landen, deputy state epidemiologist.

"Nationally and in New Mexico, fall deaths are increasing, and it's generally in people 65 or older, due to broken hips and hip fractures," Landen said.

"But basically we're not getting enough information about these deaths to determine what's going on or why our rates are higher."

In the most recent statistics, from 2003-04, the national Centers for Disease Control and Prevention in Atlanta catalogued 463 falling deaths in New Mexico — a little more than 12 deaths per 100,000 people. The national average was 6.17 per 100,000.

The highest rate was in Wisconsin, with a little more than 14 deaths per 100,000.

The statistics were contained in a CDC report Nov. 1 on accidental deaths nationwide.

Tim Stepetic, director of operations at the New Mexico Office of the Medical Investigator in Albuquerque, said one possible explanation could simply be the way falling deaths are reported in New Mexico.

"I think New Mexico isn't higher in actuality, but is higher in the number of cases because of our reporting system," Stepetic said. "We report falling deaths but also deaths that came from complications from a fall, and we compile that for the whole state."

Somebody who fell down and broke his or her hip and then spent months in the hospital and died of a complication would, for example, be reported in the falling death category.

But Landen says there's more to the statistics than just the state's reporting system.

"I think this is real," Landen said. "And I think we need to get more specific information about these deaths."

Two prevalent factors in New Mexico that could be causing the problem are poverty and substance abuse, Landen said.

"We're unsure about what extent substance abuse plays in falling deaths, but in New Mexico we generally do have a lot of deaths related to substance abuse," Landen said.

People who abuse drugs or alcohol are more likely to have motor skills problems, which could lead to them tripping over things, he said.

And poverty could lead to poor infrastructure — rickety stairs, uneven floors, poorly maintained walkways — or a lack of medical help in some of those instances, he said.

"We also need to do a better job of assuring that we minimize medication interactions among the elderly," Landen said, adding that the elderly might get medications from different sources and not be aware of which ones interact with each another.

"And as a state we need to assure that people get proper vision care and increase exercise programs available to them."

The New Mexico Healthy Aging Collaborative is working on some of those programs, Landen said, but more details about how falling deaths have occurred would help the state find a way to reduce the incidence, he said.

"We don't know if people are tripping on things in their homes, slipping on loose rugs or falling on ice," Landen said. "It's hard to get a handle on it, because we don't understand it adequately."