Skip to main content
Erschienen in: Osteoporosis International 10/2006

01.10.2006 | Original Article

The role of socioeconomic status on hip fracture

verfasst von: D. S. Zingmond, N. F. Soohoo, S. L. Silverman

Erschienen in: Osteoporosis International | Ausgabe 10/2006

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Melton LJ 3rd (2003) Adverse outcomes of osteoporotic fractures in the general population. J Bone Miner Res 18:1139–1141PubMedCrossRef Melton LJ 3rd (2003) Adverse outcomes of osteoporotic fractures in the general population. J Bone Miner Res 18:1139–1141PubMedCrossRef
2.
Zurück zum Zitat Cooper C, Atkinson EJ, Jacobsen SJ, O’Fallon WM, Melton LJ 3rd (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMed Cooper C, Atkinson EJ, Jacobsen SJ, O’Fallon WM, Melton LJ 3rd (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137:1001–1005PubMed
3.
Zurück zum Zitat Browner WS, Pressman AR, Nevitt MC, Cummings SR (1996) Mortality following fractures in older women. The study of osteoporotic fractures. Arch Intern Med 156:1521–1525PubMedCrossRef Browner WS, Pressman AR, Nevitt MC, Cummings SR (1996) Mortality following fractures in older women. The study of osteoporotic fractures. Arch Intern Med 156:1521–1525PubMedCrossRef
4.
Zurück zum Zitat Braithwaite RS, Col NF, Wong JB (2003) Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc 51:364–370PubMedCrossRef Braithwaite RS, Col NF, Wong JB (2003) Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc 51:364–370PubMedCrossRef
5.
Zurück zum Zitat Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767PubMedCrossRef Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767PubMedCrossRef
6.
Zurück zum Zitat Bacon WE, Hadden WC (2000) Occurrence of hip fractures and socioeconomic position. J Aging Health 12:193–203PubMedCrossRef Bacon WE, Hadden WC (2000) Occurrence of hip fractures and socioeconomic position. J Aging Health 12:193–203PubMedCrossRef
7.
Zurück zum Zitat Farahmand BY, Persson PG, Michaelsson K, Baron JA, Parker MG, Ljunghall S (2000) Socioeconomic status, marital status and hip fracture risk: a population-based case–control study. Osteoporos Int 11:803–808PubMedCrossRef Farahmand BY, Persson PG, Michaelsson K, Baron JA, Parker MG, Ljunghall S (2000) Socioeconomic status, marital status and hip fracture risk: a population-based case–control study. Osteoporos Int 11:803–808PubMedCrossRef
8.
Zurück zum Zitat Elffors I, Allander E, Kanis JA, Gullberg B, Johnell O, Dequeker J, Dilsen G, Gennari C, Lopes Vaz AA, Lyritis G et al (1994) The variable incidence of hip fracture in southern Europe: the MEDOS study. Osteoporos Int 4:253–263PubMedCrossRef Elffors I, Allander E, Kanis JA, Gullberg B, Johnell O, Dequeker J, Dilsen G, Gennari C, Lopes Vaz AA, Lyritis G et al (1994) The variable incidence of hip fracture in southern Europe: the MEDOS study. Osteoporos Int 4:253–263PubMedCrossRef
9.
Zurück zum Zitat Marín G, Gamba RJ (1996) A new measurement of acculturation for Hispanics: the bidimensional acculturation scale for Hispanics (BAS). Hispanic J Behav Sci 18:297–316CrossRef Marín G, Gamba RJ (1996) A new measurement of acculturation for Hispanics: the bidimensional acculturation scale for Hispanics (BAS). Hispanic J Behav Sci 18:297–316CrossRef
10.
Zurück zum Zitat Marín G (1992) Issues in the measurement of acculturation among Hispanics. In: Geisinger KF (ed) Psychological testing of Hispanics APA science volumes. American Psychological Association, Washington, DC, USA, pp 235–251, URL http://www.apa.org/books CrossRef Marín G (1992) Issues in the measurement of acculturation among Hispanics. In: Geisinger KF (ed) Psychological testing of Hispanics APA science volumes. American Psychological Association, Washington, DC, USA, pp 235–251, URL http://​www.​apa.​org/​books CrossRef
11.
Zurück zum Zitat Arcia E, Skinner M, Bailey D, Correa V (2001) Models of acculturation and health behaviors among Latino immigrants to the US. Soc Sci Med 53:41–53PubMedCrossRef Arcia E, Skinner M, Bailey D, Correa V (2001) Models of acculturation and health behaviors among Latino immigrants to the US. Soc Sci Med 53:41–53PubMedCrossRef
12.
Zurück zum Zitat Stephenson M (2000) Development and validation of the Stephenson Multigroup Acculturation Scale (SMAS). Psychol Assess 12:77–88PubMedCrossRef Stephenson M (2000) Development and validation of the Stephenson Multigroup Acculturation Scale (SMAS). Psychol Assess 12:77–88PubMedCrossRef
13.
Zurück zum Zitat Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47:1245–1251PubMedCrossRef Charlson M, Szatrowski TP, Peterson J, Gold J (1994) Validation of a combined comorbidity index. J Clin Epidemiol 47:1245–1251PubMedCrossRef
14.
Zurück zum Zitat Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383PubMedCrossRef Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383PubMedCrossRef
15.
Zurück zum Zitat US census (2004) Summary file 3-2000 census of population and housing—technical documentation. In: Commerce USDo (ed) US Department of Commerce Economics and Statistics Administration US census (2004) Summary file 3-2000 census of population and housing—technical documentation. In: Commerce USDo (ed) US Department of Commerce Economics and Statistics Administration
16.
Zurück zum Zitat US census (2004) ZIP code tabulation area (ZCTA): frequently asked questions. In: US census US census (2004) ZIP code tabulation area (ZCTA): frequently asked questions. In: US census
17.
Zurück zum Zitat Cummings SR, Nevitt, MC, Browner WS, Stone K, Fox KM, Ensrud KE, Cauley J, Black D, Vogt TM, The Study of Osteoporotic Fractures Research (1995) Risk factors for hip fracture in white women. N Engl J Med 332:767–774PubMedCrossRef Cummings SR, Nevitt, MC, Browner WS, Stone K, Fox KM, Ensrud KE, Cauley J, Black D, Vogt TM, The Study of Osteoporotic Fractures Research (1995) Risk factors for hip fracture in white women. N Engl J Med 332:767–774PubMedCrossRef
18.
Zurück zum Zitat Wang MC, Dixon LB (2006) Socioeconomic influences on bone health in postmenopausal women: findings from NHANES III, 1988–1994. Osteoporos Int 17:91–98PubMedCrossRef Wang MC, Dixon LB (2006) Socioeconomic influences on bone health in postmenopausal women: findings from NHANES III, 1988–1994. Osteoporos Int 17:91–98PubMedCrossRef
19.
Zurück zum Zitat Elliot JR, Gilchrist NL, Wells JE (1996) The effect of socioeconomic status on bone density in a male Caucasian population. Bone 18:371–373PubMedCrossRef Elliot JR, Gilchrist NL, Wells JE (1996) The effect of socioeconomic status on bone density in a male Caucasian population. Bone 18:371–373PubMedCrossRef
20.
Zurück zum Zitat del Rio Barquero L, Romera Baures M, Pavia Segura J, Setoain Quinquer J, Serra Majem L, Garces Ruiz P, Lafuente Navarro C, Domenech Torne FM (1992) Bone mineral density in two different socio-economic population groups. Bone Miner 18:159–168CrossRef del Rio Barquero L, Romera Baures M, Pavia Segura J, Setoain Quinquer J, Serra Majem L, Garces Ruiz P, Lafuente Navarro C, Domenech Torne FM (1992) Bone mineral density in two different socio-economic population groups. Bone Miner 18:159–168CrossRef
21.
Zurück zum Zitat Pearson D, Taylor R, Masud T (2004) The relationship between social deprivation, osteoporosis, and falls. Osteoporos Int 15:132–138PubMedCrossRef Pearson D, Taylor R, Masud T (2004) The relationship between social deprivation, osteoporosis, and falls. Osteoporos Int 15:132–138PubMedCrossRef
22.
Zurück zum Zitat Crespo CJ, Smit E, Andersen RE, Carter-Pokras O, Ainsworth BE (2000) Race/ethnicity, social class and their relation to physical inactivity during leisure time: results from the Third National Health and Nutrition Examination Survey, 1988–1994. Am J Prev Med 18:46–53PubMedCrossRef Crespo CJ, Smit E, Andersen RE, Carter-Pokras O, Ainsworth BE (2000) Race/ethnicity, social class and their relation to physical inactivity during leisure time: results from the Third National Health and Nutrition Examination Survey, 1988–1994. Am J Prev Med 18:46–53PubMedCrossRef
23.
Zurück zum Zitat Brennan RM, Wactawski-Wende J, Crespo CJ, Dmochowski J (2004) Factors associated with treatment initiation after osteoporosis screening. Am J Epidemiol 160:475–483PubMedCrossRef Brennan RM, Wactawski-Wende J, Crespo CJ, Dmochowski J (2004) Factors associated with treatment initiation after osteoporosis screening. Am J Epidemiol 160:475–483PubMedCrossRef
24.
Zurück zum Zitat Finley C, Gregg EW, Solomon LJ, Gay E (2001) Disparities in hormone replacement therapy use by socioeconomic status in a primary care population. J Community Health 26:39–50PubMedCrossRef Finley C, Gregg EW, Solomon LJ, Gay E (2001) Disparities in hormone replacement therapy use by socioeconomic status in a primary care population. J Community Health 26:39–50PubMedCrossRef
25.
Zurück zum Zitat Chevalley T, Herrmann FR, Delmi M, Stern R, Hoffmeyer P, Rapin CH, Rizzoli R (2002) Evaluation of the age-adjusted incidence of hip fractures between urban and rural areas: the difference is not related to the prevalence of institutions for the elderly. Osteoporos Int 13:113–118PubMedCrossRef Chevalley T, Herrmann FR, Delmi M, Stern R, Hoffmeyer P, Rapin CH, Rizzoli R (2002) Evaluation of the age-adjusted incidence of hip fractures between urban and rural areas: the difference is not related to the prevalence of institutions for the elderly. Osteoporos Int 13:113–118PubMedCrossRef
26.
Zurück zum Zitat Mannius S, Mellstrom D, Oden A, Rundgren A, Zetterberg C (1987) Incidence of hip fracture in western Sweden 1974–1982. Comparison of rural and urban populations. Acta Orthop Scand 58:38–42PubMedCrossRef Mannius S, Mellstrom D, Oden A, Rundgren A, Zetterberg C (1987) Incidence of hip fracture in western Sweden 1974–1982. Comparison of rural and urban populations. Acta Orthop Scand 58:38–42PubMedCrossRef
27.
Zurück zum Zitat Sanders KM, Nicholson GC, Ugoni AM, Seeman E, Pasco JA, Kotowicz MA (2002) Fracture rates lower in rural than urban communities: the Geelong osteoporosis study. J Epidemiol Community Health 56:466–470PubMedCrossRef Sanders KM, Nicholson GC, Ugoni AM, Seeman E, Pasco JA, Kotowicz MA (2002) Fracture rates lower in rural than urban communities: the Geelong osteoporosis study. J Epidemiol Community Health 56:466–470PubMedCrossRef
28.
Zurück zum Zitat Sernbo I, Johnell O, Andersson T (1988) Differences in the incidence of hip fracture. Comparison of an urban and a rural population in southern Sweden. Acta Orthop Scand 59:382–385PubMed Sernbo I, Johnell O, Andersson T (1988) Differences in the incidence of hip fracture. Comparison of an urban and a rural population in southern Sweden. Acta Orthop Scand 59:382–385PubMed
29.
Zurück zum Zitat Schiller JS, Adams PF, Nelson ZC (2005) Summary health statistics for the US population: National Health Interview Survey, 2003. Vital Health Stat 10:1–104 Schiller JS, Adams PF, Nelson ZC (2005) Summary health statistics for the US population: National Health Interview Survey, 2003. Vital Health Stat 10:1–104
30.
Zurück zum Zitat Ford ME, Kelly PA (2005) Conceptualizing and categorizing race and ethnicity in health services research. Health Serv Res 40:1658–1675PubMedCrossRef Ford ME, Kelly PA (2005) Conceptualizing and categorizing race and ethnicity in health services research. Health Serv Res 40:1658–1675PubMedCrossRef
31.
Zurück zum Zitat Acheson SD (1998) Independent inquiry into inequalities in health. In: Stationary Office Acheson SD (1998) Independent inquiry into inequalities in health. In: Stationary Office
32.
Zurück zum Zitat US Department of Health and Human Services (2004) Bone health and osteoporosis: a report of the Surgeon General. US Department of Health and Human Services, Public Health Service, Office of the Surgeon General, Rockville, MD US Department of Health and Human Services (2004) Bone health and osteoporosis: a report of the Surgeon General. US Department of Health and Human Services, Public Health Service, Office of the Surgeon General, Rockville, MD
33.
Zurück zum Zitat US Department of Health and Human Services (2000) Objective 15–28. Reduce hip fractures among older adults. In: Healthy people 2010, 2nd edn. With understanding and improving health and objectives for improving health, 2 vols. US Government Printing Office, Washington, DC US Department of Health and Human Services (2000) Objective 15–28. Reduce hip fractures among older adults. In: Healthy people 2010, 2nd edn. With understanding and improving health and objectives for improving health, 2 vols. US Government Printing Office, Washington, DC
34.
Zurück zum Zitat Steenland K, Hu S, Walker J (2004) All-cause and cause-specific mortality by socioeconomic status among employed persons in 27 US states, 1984–1997. Am J Public Health 94:1037–1042PubMedCrossRef Steenland K, Hu S, Walker J (2004) All-cause and cause-specific mortality by socioeconomic status among employed persons in 27 US states, 1984–1997. Am J Public Health 94:1037–1042PubMedCrossRef
Metadaten
Titel
The role of socioeconomic status on hip fracture
verfasst von
D. S. Zingmond
N. F. Soohoo
S. L. Silverman
Publikationsdatum
01.10.2006
Verlag
Springer-Verlag
Erschienen in
Osteoporosis International / Ausgabe 10/2006
Print ISSN: 0937-941X
Elektronische ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-006-0161-7

Weitere Artikel der Ausgabe 10/2006

Osteoporosis International 10/2006 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.