All new hip fractures referred to hospital in 1989 were recorded in se
ven urban populations from Denmark, Finland, Norway and Sweden. The to
tal population at risk (50 years and older) was 588 427, and 4075 frac
tures were observed (76.5 % women). In all cities an age-dependent inc
rease in incidence was found, and the female incidence was highest. Wh
en comparing the incidence rates after direct standardization, signifi
cant differences in hip fracture incidence were found between the citi
es for both women and men. The standardized relative rates seemed to d
ecrease when moving south and east with the lowest rates found in Tamp
ere, Finland. This indicates that factors which differ even between ur
ban populations within a restricted geographical region may have an im
portant impact on hip fracture incidence.