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The epidemiology of fractures in England
  1. L J Donaldson1,
  2. I P Reckless1,
  3. S Scholes2,
  4. J S Mindell3,
  5. N J Shelton3
  1. 1
    Department of Health, London, UK
  2. 2
    National Centre for Social Research, London, UK
  3. 3
    Department of Epidemiology and Public Health, University College London, London, UK
  1. L J Donaldson, Department of Health, London; liam.donaldson{at}


Introduction: Fractures are a considerable public health burden in the United Kingdom but information on their epidemiology is limited.

Objective: This study aims to estimate the true annual incidence and lifetime prevalence of fractures in England, within both the general population and specific groups, using a self-report methodology.

Methods: A self-report survey of a nationally representative general population sample of 45 293 individuals in England, plus a special boost sample of 10 111 drawn from the ethnic minority population.

Results: The calculated fracture incidence is 3.6 fractures per 100 people per year. Lifetime fracture prevalence exceeds 50% in middle-aged men, and 40% in women over the age of 75 years. Fractures occur with reduced frequency in the non-white population: this effect is seen across most black and minority ethnic groups.

Conclusions: This study suggests that fractures in England may be more common than previously estimated, with an overall annual fracture incidence of 3.6%. Age-standardised lifetime fracture prevalence is estimated to be 38.2%. Fractures are more commonplace in the white population.

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  • Funding: The Health Survey for England (HSE) is funded by the Department of Health, England.

  • Competing interests: None.

  • Guarantor:

  • Contributors: Originator of research: LJD; data collection: staff of the Joint Health Surveys Unit of NatCen and UCL; planning of analyses: all authors and B Sweeney; data analyses: SS; interpretation of results: all authors; first draft of manuscript: IPR; revisions to drafts: all authors.

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