The role of socioeconomic status on hip fracture.

Full Abstract

INTRODUCTION:
The impact of socioeconomic status-income and acculturation-on hip fracture is not well understood. We studied 116,919 fractures among 8,144,469 people in California. Greater income and English fluency predict lower fracture incidence. Lower income and immigrant populations are at increased risk for hip fracture and require intervention. Race/ethnicity is a major determinant of hip fracture risk. Although socioeconomic status (e.g., income and acculturation) is often associated with race/ethnicity, its impact on hip fracture incidence is less well understood.

METHODS:
We carried out a retrospective, population-based, study of persons with hip fractures in California, 1996 to 2000, compared to census estimates by zip code. We performed Poisson regression analyses to calculate hip fracture incident rate ratios for gender, age, race/ethnicity, income, language (percent non-English speakers)-a proxy for acculturation-and living in rural areas.

RESULTS:
During the 5-year period, 116,919 fractures occurred among 8,144,469 persons (2.87 fractures/1,000 persons per year). Higher income predicted lower hip fracture incidence. Persons in the highest decile of estimated income had an incident rate ratio (IRR) of 0.79 (95% confidence interval (CI) 0.77 to 0.82) compared with those in the lowest decile. Greater IRR of hip fracture was predicted for persons living in areas with a greater percent of non-English speakers (IRR 1.004, 95% CI 1.003 to 1.005).

CONCLUSIONS:
Low income and language fluency are predictors of greater hip fracture incidence. Although much attention is given to the aging of the "baby boomers", low income and immigrant populations are at increased risk for hip fracture and require intervention.

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Author information

Author/s: Zingmond, D S (DS); Soohoo, N F (NF); Silverman, S L (SL);

Affiliation: Division of General Internal Medicine and Health Services Research, Department of Medicine, The David Geffen School of Medicine at UCLA, 911 Broxton Plaza, Los Angeles, CA, 90095-1736, USA. dzingmond(-atsign-)mednet.ucla.edu

Grants: K08 AG023024-01A1 (Agency:NIA NIH HHS)

Journal and publication information

Publication Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

Journal: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (Osteoporos Int), published in England. (Language: eng)

Reference: 2006-Oct; vol 17 (issue 10) : pp 1562-8

Dates: Created 2006/09/13; Completed 2007/09/11; Revised 2007/12/03;

PMID: 16775669, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Female
Hip Fractures - epidemiology; etiology
Humans
Male
Middle Aged
Multilingualism
Socioeconomic Factors

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