Geographical variations in hip fracture risk for women: strong effects hidden in standardised ratios

Abstract

The risk of fracture may be different between women of the same age. This may be hidden in a comparison of standardised ratios. This finding should be considered when examining risk factors and implementing public health interventions.

Change in hip fracture incidence over the last 6 years in France

“…A number of unknown factors might have an impact on the result, including geographical variation in hip fracture risk in women with a south-to-north increase in incidence as shown recently [20].…”

International variation in proximal femur bone mineral density

“…These factors also influence the variation in proximal femur BMD, hip fracture risk and the incidence rate for hip fracture that is evident between countries or continents [17][18][19]. Although proximal femur BMD is an bottom right).…”

Secular trends of hip fractures in Québec, Canada

“…The highest incidences have been found in Northern Europe (Scandinavia) and North America [7][8][9]. Significant variations have also been reported within the same country in the USA, Canada, Japan, Spain and France [10][11][12][13][14][15] and within the same city, such as in Oslo [16]. The causes and determinants of these differences seem to be multiple and include factors related to socioeconomic status, lifestyle (such as physical exercise and nutrition), genetic diversity and the level of regional economic development [10,14,17].…”