Socioeconomic status, marital status and hip fracture risk: A population-based case-control study

Socioeconomic status and social support have been identified as important d eterminants of several diseases and overall mortality, but these factors ha ve not been adequately examined in relation to hip fracture risk, The aim o f this study was to determine the relationship of socioeconomic status and marital status to hip fracture risk. We used data from a population-based c ase-control study in postmenopausal women aged 50-81 years during 1993-1995 who resided in six counties in Sweden. The analysis was based on 1327 inci dent cases of hip fracture and 3262 randomly selected controls. Socioeconom ic and marital status were obtained by record linkage with census data in 1 960, 1970, 1980 and 1990. Information on other possible risk factors for hi p fracture was collected by a mailed questionnaire. Women who were gainfull y employed in 1990 had an odds ratio (OR) of 0.74 [95% confidence interval (CI) 0.56-0.96] compared with those not gainfully employed; those in the hi ghest tertile of household income had an OR of 0.74 (95% CI 0.60 0.90) comp ared with those in the lowest tertile of income. Women who lived in a one-f amily house had an OR of 0.85 (95% CI 0.72-0.99) compared with those living in an apartment. Divorced, widowed or unmarried women had a higher risk of hip fracture than married or cohabiting women; the OR was 1.40 (95% CI 1.0 6-1.85). Married women who were both gainfully employed and were living in a one-family house had a substantially decreased risk of hip fracture compa red with unemployed women living without a partner in an apartment (OR 0.39 ; 95% CI 0.22-0.71). Occupational affiliation among women ever employed, an d educational level, were not associated with hip fracture risk. We conclud e that employment, household income, type of housing and marital status see m to be risk indicators of hip fracture risk independent of known osteoporo tic risk factors.