Hip fractures among the elderly in a Swedish urban setting: Different perspectives on the significance of country of birth

Abstract

Objectives: The study investigates the significance of country of birth for hip fractures among the elderly in a Swedish urban setting. Design: Cross-sectional register-based study. Methods: All people aged 65 or above hospitalized because of hip fracture in Stockholm County over the years 1993—95 were identified in the County's Hospital Discharge Register. Information was obtained from Sweden's National Population Register on the countries of birth of the people affected (reference year: 1994). The foreign-born were grouped in two ways: according to the geographic location of their country of birth, and to the level of development of that country (as measured by the UN's Human Development Index). Age-standardized odds ratios were computed for men and women separately, with the Swedish-born elderly as reference group. Results: Many of the foreign-born groups registered significantly lower odds of hip fracture than their Swedish-born counterparts, regardless of whether countries of birth were grouped geographically or according to level of development. This applied to both men and women. Conclusions: As a whole, the Swedish elderly population has one of the highest prevalences of hip fracture in the world. When country of origin is accounted for, the foreign-born elderly are significantly less vulnerable than native Swedes. This contrasts remarkably with other health outcomes.