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Childhood and adulthood socioeconomic position and the hospital-based incidence of hip fractures after 13 years of follow-up: the role of health behaviours
  1. Frank J van Lenthe,
  2. M Avendano,
  3. E F van Beeck,
  4. Johan P Mackenbach
  1. Department of Public Health, Erasmus Medical Centre Rotterdam, Rotterdam, the Netherlands
  1. Correspondence to Frank J van Lenthe, Department of Public Health, Erasmus Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands; f.vanlenthe{at}erasmusmc.nl

Abstract

Background To investigate the association between childhood and adulthood socioeconomic position and the hospital-based incidence of hip fractures, and the contribution of health behaviours to these socioeconomic disparities.

Methods Baseline (1991) information about socioeconomic position in childhood and adulthood, behavioural factors (alcohol consumption, smoking, physical inactivity, coffee consumption) and body height of 25–74-year-old participants (n=18 810) were linked to hospital admissions for hip fractures (ICD9 code 820–821) over a follow-up period of almost 13 years.

Results During follow-up 192 hip fractures resulted in hospital admission. Childhood socioeconomic position was not associated with the incidence of hip fractures. Adjusted for body height, a lower educational level and being in a lower income proxy group were associated with an increased probability of hip fractures (HR=1.88, 95% CI 1.00 to 3.53 in the lowest education group; HR=2.39, 95% 1.46 to 3.92 in the lowest income group). Very excessive alcohol consumption, smoking and physical inactivity were associated with an increased probability of hip fractures, and contributed (10–31%) to socioeconomic disparities in hip fractures.

Conclusions The higher prevalence of unhealthy behaviour in lower socioeconomic groups in adulthood contributes moderately to socioeconomic disparities in incidence of hip fractures later in life.

  • Health behaviour
  • hip fractures
  • social inequalities

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Footnotes

  • Funding The present study is supported by grants from the Ministry of Public Health, Welfare and Sport and the Health Research and Development Council (ZonMW). We are indebted to Willem Hoogen Stoetenbeld (Prismant, Institute for Health Care Management) for his contribution to the record linkage.

  • Ethics approval The study was approved by the Erasmus Medical Center Rotterdam Ethics Committee.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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