Topical Fire reporT SerieS Volume 7, Issue 7 / February 2008

Fire Risk to Older Adults

continued on next page

These short topical reports 

are designed to explore facets of the U.S. fire problem 

as depicted through data 

collected in USFA’s National 

Fire Incident Reporting System (NFIRS). Each topical 

report briefly addresses the 

nature of the specific fire or 

fire-related topic, highlights 

important findings from the 

data, and may suggest other 

resources to consider for further information.

Findings

■ The elderly continue to experience a disproportionate share of fire deaths: In 2004, older 

adults (over 64 years old) represented 12% of the U.S. population but suffered more than 

30% of all fire deaths. 

■ The relative risk of individuals aged 65 and over dying in a fire is 2.6 times greater than that 

of the general population. The risk worsens as age increases: the risk is 1.7 for adults aged 

65 to 74, but soars to 4.7 for those over age 84. 

■ Older American Indians/Alaska Natives and African-Americans are at much greater risk of 

dying in a fire than their Asian/Pacific Islander or white fellow citizens. Older Asian/Pacific 

Islanders have nearly the same relative risk as the general population.

■ Older males are over 50% more likely to die in fires than older women.

■ The elderly are more vulnerable in a fire than the general population due to a combination 

of factors including mental and physical frailties, greater use of medications, and elevated 

likelihood of living in a poverty situation. 

Older Americans are burdened with the gravest fire risk 

in the United States, and are consistently more threatened with injury or death by fire than any other segment of 

society. While admirable strides have been made in lowering 

the overall U.S. fire death rate in the last decade, fewer gains 

have been realized among the oldest age groups. This Topical 

Fire Report explores the risk of fire death in the older adult 

population and is an update to The Fire Risk to Older Adults, 

Volume 4, Issue 9.

According to the National Center for Health Statistics 

(NCHS) data, nearly 4,000 deaths were caused by fire in 

2004.1

 Older adults were disproportionately the victims—

fire fatalities among persons aged 65 years or older in 2004 

were 1,265, accounting for nearly 32% of all fire casualties 

that year. 

Older adults comprise 12% of the U.S. population,2

 and 

their ranks are growing. It is estimated that the older 

population will rise sharply between 2010 and 2030, the 

years when the baby boom generation will be in retirement. By 2030, the Department of Health and Human 

Services’ Administration on Aging estimates adults aged 65 

and over will comprise 20% of the U.S. population.3

 Better 

health care and new developments in medicine continue to 

increase American life expectancy. By their 65th birthday, on 

average, Americans can expect to live another 19 years.4

At close to one-third of total fire deaths, the number of 

older Americans who die in fires across the Nation clearly 

is high. The issue becomes even more concerning when the 

relative risk of fire death encountered by older Americans is 

compared to the rest of the adult population. 

Defining Risk 

There are several ways to address the concept of risk with 

respect to fire casualties: absolute numbers of deaths and 

injuries, proportions (percent) of these casualties, rates (per 

unit, usually fires or population), and relative risk. Each 

measure is useful but in different ways, and each has its 

drawbacks. The absolute number of casualties is an important consideration—it is a concrete measure of the size or 

magnitude of the problem, but does not address the magnitude relative to other aspects of the problem. In this case, 

U.S. Department of Homeland Security • U.S. Fire Administration

National Fire Data Center • Emmitsburg, Maryland 21727

www.usfa.dhs.gov/statistics/reports/index.shtm
TFRS Volume 7, Issue 7/ Fire Risk to Older Adults Page 2

continued on next page

proportions are used to compare the relative size of the 

problem. Yet these proportions do not convey the magnitude 

of the problem, as do the absolute numbers of casualties. 

Neither of these two measures is useful for comparisons 

across different groups. For comparison across groups, a 

common basis is used to determine rates. These rates then 

account for any differences in group sizes that might affect 

the size of the problem.5

 In comparing fire rates, the relative risk of dying or being injured is a helpful measure. The 

relative risk of a group is calculated by comparing its rate 

to the rate of the overall population. The result is a measure 

of how likely a particular group is to be affected. A detailed 

discussion of per capita rates and relative risk can be found 

in the Topical Fire Report Series report, Fire Risk in 2004 

(Volume 7, Issue 5, February 2008). 

Elevated Risk for Older Adults

To be old is, in itself, a disadvantage in terms of fire risk. A 

disproportionate number of mature adults, aged 65 years 

and older, die in fires each year. Mature adults can expect a 

relative risk of dying—that is, the per capita deaths per population of mature adults—in a fire that is 2.6 times higher 

than that for the population as a whole. This statistic alone 

is troublesome, but when some subcategories of mature 

adults are more closely evaluated, the situation worsens. 

The relative risk of dying in a fire rises substantially for the 

oldest segment (Table 1 and Figure 1). Individuals aged 85 

or older are 4.7 times more likely to die in a fire than the 

general population, while those adults aged 65 to 74 are 

only 1.7 times more likely to suffer fire-related deaths. 

Table 1. Relative Risk of Older Adult Fire Deaths by Age, Race, and Gender, 2004.

Gender/Race Population Fire Deaths

Death Rate 

per Million Population Relative Risk

All Older Adults (Aged 65 and older)

Total 36,309,400 1,263 34.8 2.6

Male 15,157,782 664 43.8 3.2

Female 21,151,618 599 28.3 2.1

White 31,786,451 970 30.5 2.2

African-American 3,046,789 266 87.3 6.4

American Indian/ 

Alaska Native 181,260 12 66.2 4.9

Asian/Pacific 1,076,331 15 13.9 1.0

White Male 13,358,167 515 38.6 2.8

African-American Male 1,167,494 139 119.1 8.8

American Indian/ 

Alaska Native Male 79,090 5 63.2 4.6

Asian/Pacific Male 460,426 5 10.9 0.8

White Female 18,428,284 455 24.7 1.8

African-American Female 1,879,295 127 67.6 5.0

American Indian/ 

Alaska Native Female 102,170 7 68.5 5.0

Asian/Pacific Female 615,905 10 16.2 1.2

Aged 65 to 74

Total 18,479,964 428 23.2 1.7

Male 8,436,282 266 31.5 2.3
TFRS Volume 7, Issue 7/ Fire Risk to Older Adults Page 3

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Gender/Race Population Fire Deaths

Death Rate

per Million Population Relative Risk

Female 10,043,682 162 16.1 1.2

White 15,896,497 323 20.3 1.5

African-American 1,713,716 90 52.5 3.9

American Indian/

Alaska Native 109,077 7 64.2 4.7

Asian/Pacific 635,544 8 12.6 0.9

White Male 7,332,993 202 27.5 2.0

African-American Male 713,435 58 81.3 6.0

American Indian/

Alaska Native Male 50,457 4 79.3 5.8

Asian/Pacific Male 282,426 2 7.1 0.5

White Female 8,563,504 121 14.1 1.0

African-American Female 1,000,281 32 32.0 2.4

American Indian/

Alaska Native Female 58,620 3 51.2 3.8

Asian/Pacific Female 353,118 6 17.0 1.2

Aged 75 to 84

Total 12,980,959 528 40.7 3.0

Male 5,221,909 272 52.1 3.8

Female 7,759,050 256 33.0 2.4

White 11,532,236 409 35.5 2.6

African-American 983,827 111 112.8 8.3

American Indian/

Alaska Native 53,985 4 74.1 5.4

Asian/Pacific 341,632 4 11.7 0.9

White Male 4,675,622 213 45.6 3.4

African-American Male 355,284 57 160.4 11.8

American Indian/

Alaska Native Male 22,679 1 44.1 3.2

Asian/Pacific Male 140,382 1 7.1 0.5

White Female 6,856,614 196 28.6 2.1

African-American Female 628,543 54 85.9 6.3

American Indian/

Alaska Native Female 31,306 3 95.8 7.0

Asian/Pacific Female 201,250 3 14.9 1.1
TFRS Volume 7, Issue 7/ Fire Risk to Older Adults Page 4

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Gender/Race Population Fire Deaths

Death Rate 

per Million Population Relative Risk

Aged 85 and older

Total 4,848,477 307 63.3 4.7

Male 1,499,591 126 84.0 6.2

Female 3,348,886 181 54.0 4.0

White 4,357,718 238 54.6 4.0

African-American 349,246 65 186.1 13.7

American Indian/ 

Alaska Native 18,198 1 55.0 4.0

Asian/Pacific 99,155 3 30.3 2.2

White Male 1,349,552 100 74.1 5.4

African-American Male 98,775 24 243.0 17.9

American Indian/ 

Alaska Native Male 5,954 0 0.0 0.0

Asian/Pacific Male 37,618 2 53.2 3.9

White Female 3,008,166 138 45.9 3.4

African-American Female 250,471 41 163.7 12.0

American Indian/ 

Alaska Native Female 12,244 1 81.7 6.0

Asian/Pacific Female 61,537 1 16.3 1.2

Source: National Center for Health Statistics, 2004 Mortality Data; and Population Division, U.S. Census Bureau (Release Date: May 17, 2007) 

Table 1: Annual Estimates of the Population for the United States, Regions, and States and for Puerto Rico: April 1, 2000 to July 1, 2006 (NST-EST2006-01); 

Table 1: Annual Estimates of the Population by Five-Year Age Groups and Sex for the United States: April 1, 2000 to July 1, 2006 (NC-EST2006-01); 

Table 3: Annual Estimates of the Population by Sex, Race, and Hispanic or Latino Origin for the United States: April 1, 2000 to July 1, 2006 (NC-EST2006-03); 

Table 4: Annual Estimates of the White Alone Population by Age and Sex for the United States: April 1, 2000 to July 1, 2006 (NC-EST2006-04-WA); 

Table 4: Annual Estimates of the Black or African-American Alone Population by Age and Sex for the United States: April 1, 2000 to July 1, 2006 (NC-EST2006-04-BA); 

Table 4: Annual Estimates of the American Indian and Alaska Native Alone Population by Age and Sex for the United States: April 1, 2000 to July 1, 2006 (NC-EST2006-04-IA); 

Table 4: Annual Estimates of the Asian Alone Population by Age and Sex for the United States: April 1, 2000 to July 1, 2006 (NC-EST2006-04-AA); and

Table 4: Annual Estimates of the Native Hawaiian and Other Pacific Islander Alone Population by Age and Sex for the United States: April 1, 2000 to July 1, 2006 (NC-EST2006-04-NA).

Note: Relative risk may not compute due to rounding. 

Physical and Mental Limitations 

With advancing age, physical and mental capabilities 

decline, making it more difficult for older adults to see, 

smell, and hear clearly. Lessened senses increase the risk 

from fire; and when two or more senses are diminished, 

the fire risk for an individual increases dramatically. To make 

matters worse, older adults are more inclined to start a fire 

accidentally than are younger adults. Often the elderly are 

close to the source of a fire—a cooking fire or a cigarette 

fire—and their clothes or bedding ignites. Because the 

aging process affects many of the senses, elderly persons 

typically have diminished sensation to pain and thus often 

do not seek timely treatment. All of these factors combine to 

increase the risk for the elderly of death from fire. 

Older persons also tend to have physical disabilities or 

ailments that hinder their mobility. Many are confined to 

wheelchairs. Such infirmities make it difficult for the elderly 

to react to a fire threat the way a younger adult could, and 

thus exacerbate the fire risk to this segment of the population. Alzheimer’s, dementia, or other disorders that affect 

mental functions (rational thought and actions) can increase 
TFRS Volume 7, Issue 7/ Fire Risk to Older Adults Page 5

continued on next page

Figure 1. Age, Gender, and Relative Risk of Fire Fatality.

Source: Derived from Table 1.

the fire risk further through erratic or even dangerous 

behavior and the inability to recognize a hazard.

Adults 65 years of age and older receive 35% of all prescribed medications in this country.6

 Some medications 

cause drowsiness or affect judgment; others do not combine well with alcohol. This latter observation is important, 

as alcohol use is prevalent among elderly adults. According 

to the National Survey on Drug Use and Health, 38% of 

adults 65 years and older report current use of alcohol (at 

least one drink in the past 30 days).7

 Previous studies suggest 

more than 23% of adults 65 years and older report drinking 

alcohol 21 to 31 days per month.8

 Alcohol alone can impair 

mental acuity, and older adults who combine medications 

and alcohol, or who abuse alcohol, face an even higher risk of 

starting a fire, not responding quickly enough to extinguish 

one, or not escaping the premises where a fire is in progress. 

Older adults often elect to remain at home, rather than 

confront long-term stays in healthcare facilities. Seventy 

percent of home healthcare patients are over the age of 

65.9

 Home healthcare for the elderly is accompanied by an 

elevated fire risk. While no one factor is solely responsible 

for the increased fire risk to elderly persons receiving home 

healthcare, smoking in the presence of oxygen is recognized 

as one important problem. 

Americans are more likely to live in assisted living facilities as they age than in nursing homes. About 2% of all 

Americans 65 years and over live in nursing homes, and 

these tend to be the very elderly. In 2004, only 14% of 

Americans 85 years and over live in nursing homes. The 

numbers of older residents living in nursing homes have 

remained relatively constant, but the older population is 

increasing, resulting in a slight decline in the percent of the 

older population in nursing homes.10

Poverty 

When poverty and infirmity accompany old age, the fire 

risk is compounded. Elderly persons often live on fixed 

incomes. Old people who live alone live in poverty more 

frequently than those who live with a spouse or other persons. Many in this category are women who have outlived 

their husbands. One in 10 older adults lives below the 

poverty level.11

Often housing for the poor is substandard. Typically, such 

housing has not been well maintained. Building structures 

can be compromised, and building systems such as electrical and mechanical are often outdated, inadequate, or not 

operational. The result is a higher likelihood of damaged 
TFRS Volume 7, Issue 7/ Fire Risk to Older Adults Page 6

or fraying electrical wiring, faulty heating, and worn-out 

household appliances. Heating, in particular, represents an 

elevated fire danger to the elderly, who frequently feel cold. 

When the central heating plant of a home does not work 

properly, the elderly often will rely on temporary sources 

of heat, such as portable space heaters, fireplaces, or even 

cooking ovens. This problem is especially severe in southern 

locales, which experience only intermittent demands for 

heating. Indeed, many residences in the South do not have 

central heating, and occupants are forced to rely solely on 

alternative heating. 

Smoke alarms have saved many lives since the mid-1970s 

when their use was widely encouraged for the first time. 

The number of elderly persons living in housing without 

smoke alarms, or with alarms that do not work is not well 

documented. Nonetheless, even in homes with operable 

smoke alarms, an elderly person with impaired hearing is at 

an elevated risk of not responding in a timely manner. 

Race as a Risk Factor 

The risk of death or injury from fire is not uniform across 

the U.S. population and, in some ways, the distribution of 

casualties and injuries among the elderly reflect this disparity. The disadvantages of age are compounded for some 

races, and both race and gender affect an older adult’s fire 

risk. The problem is substantially more severe for AfricanAmericans and American Indians/Alaska Natives (see Fire 

Risk in 2004, Volume 7, Issue 5, February 2008). American 

Indians/Alaska Natives, as a whole, have a 60% elevated risk 

for fire death, and their older populations are even more 

vulnerable. Older American Indians/Alaska Natives have 

nearly five times the risk of fire death as the overall population (Table 1). As a group, African-Americans have nearly 

twice the relative risk of dying from fire than the general 

population. But it is the African-American elderly, those over 

age 85, who are most at risk—elderly African-American 

males had nearly 18 times the risk of the general population, and nearly four times the risk of all elderly in this age 

group; elderly African-American females have 12 times the 

risk of the general population and two and a half times the 

risk of all elderly in this age group. Although it is not likely 

that race itself predetermines a person’s fire risk, poverty, 

access to adequate health care, and subsequent poorer 

health are recognized risk factors.12 African-American 

elderly face a higher fire fatality relative risk than other racerelated groups, and that risk rises with age (Figure 2). 

Gender as a Risk Factor 

The risk of fire is not uniform across gender. For the population as a whole, men are approximately 57% more likely 

than women to be victims of fires (see Fire Risk in 2004, Vol. 

7, Issue 5, February 2008). In 2004, this disparity holds for 

older adults as well (55%), increasing to nearly double in 

the 65 to 74 age group (95%).

Figure 2. Age, Race, and Relative Risk of Fire Fatality.

continued on next page Source: Derived from Table 1.
TFRS Volume 7, Issue 7/ Fire Risk to Older Adults Page 7

Conclusion 

With an aging population, the U.S. demographic profile 

is changing rapidly. The elderly population is expected 

to increase from its current 12% of the total population 

to nearly 20% within a few decades. The assumption is 

that there will be a corresponding increase in fire deaths 

and injuries among older adults. Medical advances and 

improved healthcare could keep elderly persons vital for a 

longer time, but eventual physical and mental limitations 

are likely, and the increased risks of fire injury and death to 

this population merit special attention. 

Because older adults account for nearly a third of fire deaths 

and over 10% of fire injuries, the U.S. Fire Administration 

(USFA) has been working toward the goal of reducing fire 

deaths and injuries to older adults. A number of resources 

to help address the fire problem for adults are available. A 

Fire Safety Campaign for People 50-Plus (http://www.usfa.dhs.

gov/campaigns/50plus/) addresses lifestyle strategies of 

safe smoking, safe cooking, and safe heating to reduce the 

incidence of fires that traditionally affect older adults. 

To request additional information or to comment on this report, visit

http://www.usfa.dhs.gov/applications/feedback/index.jsp

References: 

1 Fire deaths are extracted from the 2004 NCHS mortality 

data using International Classification of Disease (ICD) codes 

F63.1,W39−W40, X00−X09, X75−76, X96−97, Y25−26, and 

Y35.1 where these codes were noted as either the underlying 

cause of death or a contributing factor in the chain of events leading to death. Under these criteria, 3,993 deaths were extracted. 

Only deaths where age was specified were used in the analyses in 

the relative risk tables. 

2 Population Division, U.S. Census Bureau, Table 1: Annual Estimates of the Population by Five-Year Age Groups and Sex for the 

United States: April 1, 2000 to July 1, 2006 (NC-EST2006-01), 

Release Date: May 17, 2007.

3Department of Health and Human Services, Administration on 

Aging, http://www.aoa.gov/prof/Statistics/future_growth/State5-yr-age-projections-2005-2030.xls

4NCHS. Health, United States 2007, Table 27, http://www.cdc.gov/

nchs/data/hus/hus07.pdf#027

5 In the case of fire casualties, this common basis is a population 

of 1 million, which means that fire rates are measured by incidents, deaths, or injuries per million persons population.

6National Institute on Drug Abuse. Research Report Series—Prescription 

Drugs: Abuse and Addiction, “Trends in prescription drug abuse,” 

http://www.nida.nih.gov/ResearchReports/Prescription/prescription5.html#Trends. Confirmed by calculations based on 

NCHS, Health, United States, 2006, Table 92. Selected prescription and 

nonprescription drugs recorded during physician office visits 

and hospital outpatient department visits, by sex and age: United 

States, 1995-1996 and 2003-2004 and Population Division, U.S. 

Census Bureau, Table 2 Annual Estimates of the Population by 

Selected Age Groups and Sex for the United States: April 1, 2000 

to July 1, 2006 (NC-EST2006-02), Release Date: May 17, 2007.

7

 Results from the 2006 National Survey on Drug Use and 

Health: National Findings, http://www.oas.samhsa.gov/

nsduh/2k6nsduh/2k6Results.cfm#3.1

8

 National Center for Chronic Disease Prevention and Health 

Promotion, Behavioral Risk Factor Surveillance System, Online 

Prevalence Data, 2002, as reported in Fire and the Older Adult, United 

States Fire Administration (USFA), January 2006.

9

 NCHS. Health, United States 2005, Table 94. http://www.cdc.gov/

nchs/data/hus/hus05.pdf#094

10 Houser, Ari. Nursing Homes: Research Report. American Association for 

Retired Persons (AARP), October 2007, http://www.aarp.org/

research/longtermcare/nursinghomes/fs10r_homes.html

11 U.S. Census Bureau, Current Population Survey, Annual Social 

and Economic Supplement, Table 15: Poverty Status of the Population Age 55 Years and Over by Sex and Age: 2005, Internet release 

date: July 27, 2007, http://www.census.gov/population/www/

socdemo/age/age_2006.html

12 Socioeconomic Factors and the Incidence of Fire. USFA, FA-170, June 1997.