title: Childhood and adulthood socioeconomic position and the hospital-based incidence of hip fractures after 13 years of follow-up: the role of health behaviours.
abstract: BACKGROUND
  To investigate the association between childhood and adulthood socioeconomic position and the hospital-based incidence of hip fractures, and the contribution of health behaviours to these socioeconomic disparities.
  
  
  METHODS
  Baseline (1991) information about socioeconomic position in childhood and adulthood, behavioural factors (alcohol consumption, smoking, physical inactivity, coffee consumption) and body height of 25-74-year-old participants (n=18 810) were linked to hospital admissions for hip fractures (ICD9 code 820-821) over a follow-up period of almost 13&emsp14;years.
  
  
  RESULTS
  During follow-up 192 hip fractures resulted in hospital admission. Childhood socioeconomic position was not associated with the incidence of hip fractures. Adjusted for body height, a lower educational level and being in a lower income proxy group were associated with an increased probability of hip fractures (HR=1.88, 95% CI 1.00 to 3.53 in the lowest education group; HR=2.39, 95% 1.46 to 3.92 in the lowest income group). Very excessive alcohol consumption, smoking and physical inactivity were associated with an increased probability of hip fractures, and contributed (10-31%) to socioeconomic disparities in hip fractures.
  
  
  CONCLUSIONS
  The higher prevalence of unhealthy behaviour in lower socioeconomic groups in adulthood contributes moderately to socioeconomic disparities in incidence of hip fractures later in life.
authors.affiliation: Department of Public Health, Erasmus Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands. f.vanlenthe@erasmusmc.nl
authors.forename: Frank J
authors.initials: FJ
authors.lastname: van Lenthe
authors.forename: M
authors.initials: M
authors.lastname: Avendano
authors.forename: E F
authors.initials: EF
authors.lastname: van Beeck
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015438:Health Behavior; D006620:Hip Fractures / Q000453:epidemiology*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012923:Social Class; D011795:Surveys and Questionnaires