PT  - JOURNAL ARTICLE
AU  - Carla Maria Oliveira
AU  - Sandra Maria Alves
AU  - Maria Fátima Pina
TI  - 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
AID  - 10.1136/jech-2015-206508
DP  - 2016 Aug 01
TA  - Journal of Epidemiology and Community Health
PG  - 755--763
VI  - 70
IP  - 8
4099  - http://jech.bmj.com/content/70/8/755.short
4100  - http://jech.bmj.com/content/70/8/755.full
SO  - J Epidemiol Community Health2016 Aug 01; 70
AB  - 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.