Abstract
Summary
The incidence hip fractures (HF) among Ethiopian immigrants is unknown. In Israel, the incidence of HF among Ethiopian immigrants aged ≥ 50 years between 2011 and 2020 was lower than in the general Israeli population, but possibly on the rise. These data should be confirmed in other countries where the Ethiopian diaspora has settled.
Purpose
The incidence of osteoporotic fractures in the aging Ethiopian population that immigrated to Western countries has not been reported. This study sought to provide a first assessment of the incidence of hip fractures in Ethiopian immigrants in Israel, as a proxy for osteoporosis in this population.
Methods
This is an epidemiologic study of the incidence of hip fractures (HF) in people aged ≥ 50 years in Israel, between 2011 and 2020. Data were extracted from the Israel National Trauma Registry (INTR). Annual age-adjusted HF incidence rates (IR), and standardized incidence ratios (SIR) among Ethiopian-born (EB) relative to non-EB subjects (others) were computed.
Results
During the study period, among subjects age ≥ 50 in the INTR, only 20.1% of the EB suffered a HF, in contrast to 32.3% of subjects from other origins (P < 0.0001). Although EB subjects were generally younger than their non-EB counterparts, the age at which they sustained a HF was similar: 80.45 ± 11.7 years for EB vs. 79.44 ± 10.32 years, P = 0.19. EB men were more likely to sustain a HF, as they represented 41.8% of all HF in their respective group, in comparison with 33.6% for others (P = 0.02). Annual IR of HF were lower for EB subjects throughout the study. Despite an initial rise in the SIR, these were also lower for most of the period.
Conclusions
In Israel, EB subjects ≥ 50 years still enjoy protection from HF. Our data require confirmation from other Western countries where the Ethiopian diaspora is aging. If a secular upward trend is observed, contributing risk factors should be identified to enable preventative measures.
This is a preview of subscription content, log in via an institution to check access.
References
https://www.cbs.gov.il/he/mediarelease/DocLib/2021/447/11_21_447e.pdf [Internet]. [cited 2023 Jan 18]. Available from: https://www.cbs.gov.il/he/mediarelease/DocLib/2021/447/11_21_447e.pdf
Ethiopian Jews, New migration models in Israel and diaspora studies [Internet]. [cited 2023 Jan 18]. Available from: http://journals.openedition.org/bcrfj/264
Population - Statistical Abstract of Israel 2021 - No.72 [Internet]. [cited 2023 Jan 18]. Available from: https://www.cbs.gov.il/en/publications/Pages/2021/Population-Statistical-Abstract-of-Israel-2021-No.72.aspx
Getahun S. The making of the Ethiopian diaspora in the US: a synopsis. https://globalafrica.isp.msu.edu/files/3715/5916/4698/SolomonGetahum.pdf [Internet]. [cited 2022 Jan 18]. Available from: https://globalafrica.isp.msu.edu/files/3715/5916/4698/SolomonGetahum.pdf
Article: Once Primarily an Origin for Refugees, Et.. | migrationpolicy.org [Internet]. [cited 2023 Jan 18]. Available from: https://www.migrationpolicy.org/article/ethiopia-origin-refugees-evolving-migration
Billek-Sawhney B (2019) Osteoporosis risk in Ethiopians African Americans– think twice about bone density. Int Phys Med Rehab J 4(3):91‒94
Baron JA, Karagas M, Barrett J, Kniffin W, Malenka D, Mayor M et al (1996) Basic epidemiology of fractures of the upper and lower limb among Americans over 65 years of age. Epidemiology 7(6):612–618
Barrett-Connor E, Siris ES, Wehren LE, Miller PD, Abbott TA, Berger ML et al (2005) Osteoporosis and fracture risk in women of different ethnic groups. J Bone Miner Res 20(2):185–194
Noel SE, Santos MP, Wright NC (2021) Racial and ethnic disparities in bone health and outcomes in the United States. J Bone Miner Res 36(10):1881–1905
Melton LJ III, Marquez MA, Achenbach SJ, Tefferi A, O’Connor MK, O’Fallon WM et al (2002) Variations in bone density among persons of African heritage. Osteoporos Int 13(7):551–559
Gong G, Haynatzki G, Haynatzka V, Kosoko-Lasaki S, Howell R, Fu Y-X et al (2006) Bone mineral density of recent African immigrants in the United States. J Natl Med Assoc 98(5):746–752
Demeke T, El-Gawad GA, Osmancevic A, Gillstedt M, Landin-Wilhelmsen K (2015) Lower bone mineral density in Somali women living in Sweden compared with African-Americans. Arch Osteoporos 19(10):208
Wändell P, Li X, Carlsson AC, Sundquist J, Sundquist K (2021) Osteoporotic fractures among foreign-born individuals: a national Swedish study. Osteoporos Int 32(2):343–352
Wändell P, Li X, Carlsson AC, Sundquist J, Sundquist K (2021) Osteoporotic fractures in second-generation immigrants and Swedish natives. Osteoporos Int 32(7):1343–1350
Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl DA, Cooper C et al (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23(9):2239–2256
Paruk F, Matthews G, Cassim B (2017) Osteoporotic hip fractures in Black South Africans: a regional study. Arch Osteoporos 12(1):107
Weiss S (2009) Alcohol use and abuse among Ethiopian immigrants to Israel: a review. Afr J Drug Alcohol Stud 7(1):27–39
Jaffe A, Giveon S, Wulffhart L, Oberman B, Freedman L, Ziv A et al (2016) Diabetes among Ethiopian immigrants To Israel: exploring the effects of migration and ethnicity on diabetes risk. PLoS One 11(6):e0157354
Bayray A, Enquselassie F, Gebreegziabher Z (2012) Magnitude and pattern of osteoporotic fractures among adults in Tigiray, Ethiopia; a retrospective hospital based study. Ethiop Med J 50(4):297–305
Acknowledgements
The authors wish to acknowledge the members of the Israel Trauma Group (ITG), A. Acker, H. Bahouth, A. Bar, A. Becker, A. Braslavsky, D. Fadeev, A. L. Goldstein, I. Grevtsev, I. Jeroukhimov, A. Kedar, Y. Klein, A. Korin, B. Levit, A. D. Schwarz, W. Shomar, D. Soffer, I. Schrier, M. Venturero, M. Weiss, O. Yaslowitz, I. Zoarets, for making this study possible.
Funding
This study received no specific funding from any source.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
None.
Additional information
Publisher's note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Tordjman, K., Rouach, V., Jaffe, A. et al. Lower incidence of hip fractures among elderly Ethiopian immigrants to Israel: first assessment from the Israel National Trauma Registry (INTR) 2011–2020. Osteoporos Int 34, 993–997 (2023). https://doi.org/10.1007/s00198-023-06698-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00198-023-06698-7