Abstract
BackgroundOnly a limited number of studies have analyzed the association between hip fracture incidence and socioeconomic conditions. Most, but not all found an association, and results are in part conflicting. The aim of our study was to evaluate the association between hip fractures and socioeconomic conditions in Germany, from 1995 to 2004, on a census tract area level.MethodsWe used data from the national hospital discharge diagnosis register and data on socioeconomic and demographic characteristics of 131 census tracts from official statistics. Associations between the hip fracture incidence and socioeconomic conditions were analyzed by multiple Poisson regression models, taking overdispersion into account.ResultsThe risk of hip fracture decreased by 4% with a 7% increase (about one interquartile range) of non-German nationals. It decreased by 10% with a 6% increased rate of unemployment, increased by 7% with a 2% increase of the proportion of welfare recipients, and also increased by 3% with an increase of the proportion of single parent families of 1.9%.ConclusionOur results showed weak associations between indicators of socioeconomic conditions at area level and hip fracture risk; the varied by type of indicator. We conclude that hip fracture incidence might be influenced by the socioeconomic context of a region, but further analysis using more specific markers for deprivation on a smaller scale and individual-level data are needed.
Highlights
A limited number of studies have analyzed the association between hip fracture incidence and socioeconomic conditions
The risk of hip fracture decreased by 4% with a 7% increase of non-German nationals
Study findings In our area-level analysis, we found only small differences in hip fracture incidence in relation to indicators of socioeconomic conditions
Summary
A limited number of studies have analyzed the association between hip fracture incidence and socioeconomic conditions. The aim of our study was to evaluate the association between hip fractures and socioeconomic conditions in Germany, from 1995 to 2004, on a census tract area level. Besides individual-level analyses, a number of area-level analyses were performed, where the effect of a contextual deprivation, e.g. living in a low income neighborhood, were examined. The evaluation of socioeconomic conditions in the individuals' environment is a complementary and more generalized concept of socioeconomic status. Both individual-level and regional-level socioeconomic indicators have been shown to be independently associated with the status of health [7,10]
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