Hip fractures among the elderly in a Swedish urban setting: Different perspectives on the significance of country of birth

Abstract

The study investigates the significance of country of birth for hip fractures among the elderly in a Swedish urban setting. Cross-sectional register-based study. All people aged 65 or above hospitalized because of hip fracture in Stockholm County over the years 1993-95 were identified in the County's Hospital Discharge Register. Information was obtained from Sweden's National Population Register on the countries of birth of the people affected (reference year: 1994). The foreign-born were grouped in two ways: according to the geographic location of their country of birth, and to the level of development of that country (as measured by the UN's Human Development Index). Age-standardized odds ratios were computed for men and women separately, with the Swedish-born elderly as reference group. Many of the foreign-born groups registered significantly lower odds of hip fracture than their Swedish-born counterparts, regardless of whether countries of birth were grouped geographically or according to level of development. This applied to both men and women. As a whole, the Swedish elderly population has one of the highest prevalences of hip fracture in the world. When country of origin is accounted for, the foreign-born elderly are significantly less vulnerable than native Swedes. This contrasts remarkably with other health outcomes.