The interactions between municipal socioeconomic status and age on hip fracture risk

• Type: Article in International Scientific Journal
• Date: 2015

Authors

Oliveira, CM (Author) Other; Economou, T (Author) Other; Bailey, T (Author) Other; Mendonca, D (Author) ICBAS; Pina, MF (Author) Other

Journal

Title: Osteoporosis International

Vol. 26

Pages: 489-498

ISSN: 0937-941X

Publisher: Springer Nature

Indexing

ISI Web of Knowledge - 16 Citations

Scopus - 19 Citations

Other information

Authenticus ID: P-00A-6X5

DOI: 10.1007/s00198-014-2869-0

Abstract (EN): Age modifies the effect of area-level socioeconomic status (SES) in the risk of fragility hip fractures (HF). For older individuals, the risk of HF increases as SES increases. For younger individuals, risk of HF increases as SES decreases. Our study may help decision-makers to better direct the implementation of political decisions. The effect of socioeconomic status (SES) on hip fracture (HF) incidence remains unclear. The objective of this study is to evaluate the association between HF incidence and municipality-level SES as well as interactions between age and SES. From the Portuguese Hospital Discharge Database, we selected hospitalizations (2000-2010) of patients aged 50+, with HF diagnosis (codes 820.x, ICD9-CM), caused by traumas of low/moderate energy, excluding bone cancer cases and readmissions for aftercare. Municipalities were classified according to SES (deprived to affluent) using 2001 Census data. A spatial Bayesian hierarchical regression model (controlling for data heterogeneity and spatial autocorrelation), using the Poisson distribution, was used to quantify the relative risk (RR) of HF, 95 % credible interval (95%CrI), and analyze the interaction between age and SES after adjusting for rural conditions. There were 96,905 HF, 77.3 % of which were on women who, on average, were older than men (mean age 81.2 +/- 8.5 vs 78.2 +/- 10.1 years) at admission (p < 0.001). In women, there was a lower risk associated with better SES: RR = 0.83 (95%CrI 0.65-1.00) for affluent versus deprived. There was an inverse association between SES and HF incidence rate in the youngest and a direct association in the oldest, for both sexes, but significant only between deprived and affluent in older ages (a parts per thousand yen75 years). Interaction between SES and age may be due to inequalities in lifestyles, access to health systems, and preventive actions. These results may help decision-makers to better understand the epidemiology of hip fractures and to better direct the available funding.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10