Marked socioeconomic inequalities in hip fracture incidence rates during the Bone and Joint Decade (2000–2010) in Portugal: age and sex temporal trends in a population based study

Abstract

Background Socioeconomic factors may influence changes in hip fracture (HF) incidence over time. We analysed HF temporal trends during the Bone and Joint Decade in Portugal (BJD-Portugal), 2000-2010, by regional socioeconomic status (SES), sex and age. Methods We selected registers of patients aged 50+ years with HF (International Classification of Diseases, V.9-Clinical Modification, ICD9-CM) caused by traumas of low/moderate energy, from the National Hospital Discharge Database. Annual time series of age-specific incidence rates were calculated by sex and regional SES (deprived, medium, affluent). Generalised additive models were fitted to identify shape/turning points in temporal trends. Results We selected 96 905 HF (77.3% in women). Women were older than men at admission (81.2±8.5 vs 78.2±10.1 years-old, p<0.001). For women 65-79 years, a continuously decreasing trend (1.7%/year) only in affluent and increasing trends (3.3-3.4%/year) after 2006/2007 in medium and deprived was observed. For men, trends were stable or increased in almost all age/SES groups (only two decreasing periods). For the oldest women, all SES present similar trends: turning points around 2003 (initiating decreasing periods: 1.8-2.9%/year) and around 2007 (initiating increasing periods: 3.7-3.3%/year). Conclusions There were SES-sex-age inequalities in temporal trends during BJD-Portugal: marked SES inequalities among women aged 65-79 years (a persistent, decreasing trend only in the affluent) vanished among the oldest women; the same was not observed in men, for them, there were almost no declining periods; women aged ≥80 years, presented increasing trends around 2007, as in most deprived/age/ sex groups. Despite some successful periods of decreasing trends, incidence rates did not improve overall in almost all age groups and both sexes.

Risk Factors Associated With Hip Fractures among Adult People in Babylon City, Iraq

“…This finding goes with findings of other researches abroad [19], [20]. Despite the problem of hip fractures considered a great public problem [19], [21], [23], actually a few studies only that have analysed the association between hip fractures and socioeconomic status, so it remains unclear.…”

“…Some of the articles found an increased incidence [20], [22], [23], [24], [25], [26], [27] while others found a decreased incidence of Hip fractures with low socioeconomic status [28], [29]. Some articles found an association with only some socioeconomic indicators [30], [33].…”

Determinantes socioeconômicos e demográficos na assistência à fratura de fêmur em idosos

“…Amongst the studies that have associated ethnic and demographic factors to fractures, particularly for older people, only a few have analyzed aspects connected to social and economic issues [15][16][17][18] and even fewer have evaluated the influence of income 19,20 . Evidence of the positive effects of wealth on the offer of services and the availability of infrastructure in health [21][22][23] , reinforces the interference of socioeconomic development in the profile of morbidities.…”

Demographic Study of Hip Fractures in the Maltese Islands

“…Hip fractures, especially in the infirm elderly individuals, have a great impact on morbidity, mortality, and duration of hospitalization, with most of these patients becoming institutionalised. 1 – 5 A coordinated multidisciplinary approach is essential in delivering the best management for hip fractures. This includes the input from orthopedic surgeons, nurses, and geriatricians; occupational therapists, physiotherapists; and social workers.…”

“…Despite hip fractures being a great public health problem, 1 , 3 – 5 only few studies have analyzed the association between hip fractures and socioeconomic conditions. However, the relationship between hip fractures and socioeconomic status remains unclear.…”