title: Epidemiology of bone fracture across the age span in blacks and whites.
abstract: BACKGROUND
  Gender and racial disparities in injury mortality have been well established, but less is known regarding differences in fracture-related hospitalizations across the age span.
  
  
  METHODS
  Cross-sectional analysis of annual incident fracture hospital admissions used statewide acute care hospital discharge data (Statewide Program and Research Cooperative System) for non-Hispanic White (n = 138,763) and non-Hispanic Black (n = 19,588) residents of New York State between 2000 and 2002. US census data with intercensal estimates were used to ascertain the population at risk. Gender- and race-specific incident fracture was calculated in 5-year age intervals. The χ test was used to analyze categorical variables.
  
  
  RESULTS
  Mechanisms of injury vary by race and gender in their relative contribution to injury-related fractures across the age span. Black males exhibited higher fracture incidence until approximately age 62, while incidence in women diverged around age 45. Total motor vehicle traffic-related fracture hospitalization is bimodal in Whites but not in Blacks. Over the life span, all groups exhibited bimodal pedestrian fractures with pedestrian fractures accounting for 8.8% and 2.5% of all fractures in Blacks and Whites, respectively. Racial disparities were present from preschool through age 70. Violence-related fractures were 10 times higher in Blacks, accounting for 18.2% of hospitalizations. Black males exhibit higher fracture incidence due to violence by age 5 and higher gun violence by age 10; both remain elevated through age 75.
  
  
  CONCLUSIONS
  Despite historical studies demonstrating higher bone density in Blacks, this study found racial disparities with increased fracture risk in both Black children and adults across most nonfall-related injury mechanisms examined.
authors.affiliation: Columbia University Department of Epidemiology, Columbia University, New York, New York 10032, USA. JP376@columbia.edu
authors.forename: Joyce C
authors.initials: JC
authors.lastname: Pressley
authors.forename: Tiffany D
authors.initials: TD
authors.lastname: Kendig
authors.forename: Stanley K
authors.initials: SK
authors.lastname: Frencher
authors.forename: Barbara
authors.initials: B
authors.lastname: Barlow
authors.forename: Lodze
authors.initials: L
authors.lastname: Quitel
authors.forename: Fauzia
authors.initials: F
authors.lastname: Waqar
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000208:ethnology* / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
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