Zingmond D S, Soohoo N F, Silverman S L
Division of General Internal Medicine and Health Services Research, Department of Medicine, The David Geffen School of Medicine at UCLA, 911 Broxton Plaza, Los Angeles, CA, 90095-1736, USA.
Osteoporos Int. 2006 Oct;17(10):1562-8. doi: 10.1007/s00198-006-0161-7. Epub 2006 Jun 15.
The impact of socioeconomic status-income and acculturation-on hip fracture is not well understood. We studied 116,919 fractures among 8,144,469 people in California. Greater income and English fluency predict lower fracture incidence. Lower income and immigrant populations are at increased risk for hip fracture and require intervention. Race/ethnicity is a major determinant of hip fracture risk. Although socioeconomic status (e.g., income and acculturation) is often associated with race/ethnicity, its impact on hip fracture incidence is less well understood.
We carried out a retrospective, population-based, study of persons with hip fractures in California, 1996 to 2000, compared to census estimates by zip code. We performed Poisson regression analyses to calculate hip fracture incident rate ratios for gender, age, race/ethnicity, income, language (percent non-English speakers)-a proxy for acculturation-and living in rural areas.
During the 5-year period, 116,919 fractures occurred among 8,144,469 persons (2.87 fractures/1,000 persons per year). Higher income predicted lower hip fracture incidence. Persons in the highest decile of estimated income had an incident rate ratio (IRR) of 0.79 (95% confidence interval (CI) 0.77 to 0.82) compared with those in the lowest decile. Greater IRR of hip fracture was predicted for persons living in areas with a greater percent of non-English speakers (IRR 1.004, 95% CI 1.003 to 1.005).
Low income and language fluency are predictors of greater hip fracture incidence. Although much attention is given to the aging of the "baby boomers", low income and immigrant populations are at increased risk for hip fracture and require intervention.
社会经济地位（收入与文化适应程度）对髋部骨折的影响尚未得到充分了解。我们对加利福尼亚州8144469人中的116919例骨折进行了研究。较高的收入和英语流利程度预示着较低的骨折发生率。低收入人群和移民群体发生髋部骨折的风险增加，需要进行干预。种族/族裔是髋部骨折风险的主要决定因素。尽管社会经济地位（如收入和文化适应程度）通常与种族/族裔相关，但其对髋部骨折发生率的影响却鲜为人知。
我们对1996年至2000年加利福尼亚州髋部骨折患者进行了一项基于人群的回顾性研究，并与按邮政编码划分的人口普查估计数进行了比较。我们进行了泊松回归分析，以计算性别、年龄、种族/族裔、收入、语言（非英语使用者百分比，作为文化适应程度的替代指标）以及居住在农村地区的髋部骨折发病率比。
在这5年期间，8144469人中有116919例骨折发生（每年每1000人中有2.87例骨折）。较高的收入预示着较低的髋部骨折发生率。估计收入最高十分位数的人群与最低十分位数的人群相比，发病率比（IRR）为0.79（95%置信区间（CI）为0.77至0.82）。对于居住在非英语使用者比例较高地区的人群，髋部骨折的IRR更高（IRR为1.004，95%CI为1.003至1.005）。
低收入和语言流利程度是髋部骨折发生率较高的预测因素。尽管“婴儿潮一代”的老龄化备受关注，但低收入人群和移民群体发生髋部骨折的风险增加，需要进行干预。
