Department of Public Health, Erasmus Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
J Epidemiol Community Health. 2011 Nov;65(11):980-5. doi: 10.1136/jech.2010.115782. Epub 2011 Feb 4.
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.
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.
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.
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.
本研究旨在探讨儿童期和成年期社会经济地位与髋部骨折住院发病率之间的关系，以及健康行为对这些社会经济差异的贡献。
将基线（1991 年）时儿童期和成年期的社会经济地位、行为因素（饮酒、吸烟、身体活动不足、咖啡饮用）和 25-74 岁参与者的身高（n=18810）与近 13 年随访期间髋部骨折（ICD9 编码 820-821）的住院情况相关联。
在随访期间，有 192 例髋部骨折导致住院。儿童期社会经济地位与髋部骨折的发病率无关。在校正身高后，较低的教育水平和较低的收入代表群体与髋部骨折的发生概率增加相关（在最低教育组中，HR=1.88，95%CI 1.00 至 3.53；在最低收入组中，HR=2.39，95%CI 1.46 至 3.92）。过度饮酒、吸烟和身体活动不足与髋部骨折的发生概率增加相关，并导致（10-31%）髋部骨折发病率的社会经济差异。
成年期社会经济地位较低的人群中不健康行为的较高发生率，在一定程度上导致了髋部骨折发病率的社会经济差异。
