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Author(s): Oliveira, C
Alves, S
Pina, MF
Title: 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
Issue Date: 2016
Abstract: 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.
Subject: Socioeconomic inequalities
Hip fracture
Source: J Epidemiol Community Health, vol. 70(8), p. 755-763
Document Type: Artigo em Revista Científica Internacional
Rights: restrictedAccess
Appears in Collections:ISPUP - Artigo em Revista Científica Internacional

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