Osteoporosis International

, Volume 17, Issue 10, pp 1562–1568 | Cite as

The role of socioeconomic status on hip fracture

Original Article



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.


Aging Hip fracture Income Osteoporosis Population studies 



This study was supported through an unrestricted grant from the Merck Research Foundation. Dr. Zingmond is funded by a Mentored Clinical Scientist Award (NIA K08 AG023024-01A1).


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2006

Authors and Affiliations

  • D. S. Zingmond
    • 1
  • N. F. Soohoo
    • 2
  • S. L. Silverman
    • 3
  1. 1.Division of General Internal Medicine and Health Services Research, Department of MedicineThe David Geffen School of Medicine at UCLALos AngelesUSA
  2. 2.UCLA Department of Orthopedic SurgeryThe David Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Division of Rheumatology, Department of MedicineThe David Geffen School of Medicine at UCLA and Cedars-Sinai Medical CenterLos AngelesUSA

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