title: Demographic factors in hip fracture incidence and mortality rates in California, 2000-2011.
abstract: BACKGROUND
  Hip fractures result in both health and cost burdens from a public health perspective and have a major impact on the health care system in the USA. The purpose was to examine whether there were systematic differences in hip fracture incidence and 30-, 90-, and 365-day mortality after hip fracture in the California population as a function of age, gender, and race/ethnicity from 2000-2011.
  
  
  METHODS
  This was a population-based study from 2000 to 2011 using data from the California Office of Statewide Health and Planning and Development (OSHPD, N = 317,677), California State Death Statistical Master File records (N = 224,899), and the US Census 2000 and 2010. There were a total of 317,677 hospital admissions for hip fractures over the 12-year span and 24,899 deaths following hip fractures. All participants without linkage (substituted for social security) numbers were excluded from mortality rate calculations. Variation in incidence and mortality rates across time, gender, race/ethnicity, and age were assessed using Poisson regression models. Odds ratio and 95 % confidence intervals are provided.
  
  
  RESULTS
  The incidence rate of hip fractures decreased between 2000 and 2011 (odds ratio (OR) = 0.98, 95 % confidence interval (CI) 0.98, 0.98). Mortality rates also decreased over time. There were gender, race/ethnicity, and age group differences in both incidence and mortality rates.
  
  
  CONCLUSIONS
  Males were half as likely to sustain a hip fracture, but their mortality within a year of the procedure is almost twice the rate than women. As age increased, the prevalence of hip fracture increased dramatically, but mortality did not increase as steeply. Caucasians were more likely to sustain a hip fracture and to die within 1 year after a hip fracture. The disparities in subpopulations will allow for targeted population interventions and opportunities for further research.
authors.affiliation: Psychological Science, UC Merced, 5200 Lake Road, Merced, CA, 95343, USA. Ksullivan7@ucmerced.edu.
authors.forename: Kristynn J
authors.initials: KJ
authors.lastname: Sullivan
authors.affiliation: Orthopaedic Surgery, UCSF-Fresno, 155 N Fresno Street, Fresno, CA, 93701, USA. lhusak@fresno.ucsf.edu.
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Husak
authors.affiliation: Orthopaedic Surgery, UCSF-Fresno, 155 N Fresno Street, Fresno, CA, 93701, USA. m.altebarmakian@gmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: Altebarmakian
authors.affiliation: Orthopaedic Surgery, Kaiser Permanente Medical Center, 7300 N Fresno Street, Fresno, CA, 93720, USA. wtimbrox@gmail.com.
authors.forename: W Timothy
authors.initials: WT
authors.lastname: Brox
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data; D002140:California / Q000453:epidemiology; D005260:Female; D006620:Hip Fractures / Q000208:ethnology* / Q000401:mortality; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D017678:Sex Distribution