Urban-rural differences in distal forearm fractures: Cohort Norway
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The prevalence of forearm fractures increased with increasing degree of urbanization for both genders in the population-based study “Cohort Norway” with more than 180,000 participants. The differences were not explained by available risk factors. Prospective studies with information on bone mineral density and falls are warranted.
The purpose was to investigate urban-rural gradients in self-reported forearm fractures and assess the contribution of possible explanatory factors.
“Cohort Norway” comprises ten population-based surveys inviting 309,742 individuals age 20 years and older. All 181,891 participants underwent a standardized examination and answered 50 common questions, including one concerning former forearm fractures. Based on the home-addresses, participants were divided into three population density groups: cities, densely populated areas and sparsely populated areas. Analyses were limited to 149,725 participants 30 years or over with valid information on exposure and outcome. Of these, 21,627 reported having suffered a forearm fracture.
The prevalence of forearm fractures increased with increasing degree of urbanization for both genders. After adjustment for age and explanatory factors, the odds ratio of having sustained a forearm fracture in men living in densely populated areas and in cities were 1.12 (95% CI, 1.04–1.21) and 1.38 (95% CI, 1.30–1.46), respectively, compared to rural areas. Similar odds ratios were observed among women.
Prospective studies are needed to verify whether lower bone mineral density, different lifestyle and/or more falls may explain the higher proportion of self-reported forearm fractures found in urban compared to rural areas.
KeywordsEpidemiology Forearm Fractures Rural population Urban population Wrist
the collaborative Norwegian study “Cohort Norway”
bone mineral density
body mass index
All data used in this paper were obtained from Cohort Norway. The authors gratefully acknowledge the services of CONOR and the contributing research centers delivering data to CONOR. Our sincere thank you goes to all participants as well as to staff-members dealing with data collection in the health surveys contributing to the CONOR database.
We would like to thank Luai Awad Ahmed, PhD, Institute of Community Medicine, University of Tromsø, Norway for his preliminary analyses of forearm fractures from the Fracture Registry at the University Hospital in Tromsø.
The CONOR collaborative group has received financial support from the Ministry of Social Affairs. The NOREPOS research group has received financial support from the Research Council of Norwegian and the Norwegian Osteoporosis Society.
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