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The association between socioeconomic status and osteoporotic fracture in population-based adults: a systematic review

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Abstract

Summary

Although socioeconomic status (SES) is inversely related to most diseases, this systematic review showed a paucity of good quality data examining influences of SES on osteoporotic fracture to confirm this relationship. Further research is required to elucidate the issue and any underlying mechanisms as a necessary precursor to considering intervention implications.

Introduction

The association between socioeconomic status (SES) and musculoskeletal disease is little understood, despite there being an inverse relationship between SES and most causes of morbidity. We evaluated evidence of SES as a risk factor for osteoporotic fracture in population-based adults.

Methods

Computer-aided search of Medline, EMBASE, CINAHL, and PsychINFO from January 1966 until November 2007 was conducted. Identified studies investigated the relationship between SES parameters of income, education, occupation, type of residence and marital status, and occurrence of osteoporotic fracture. A best-evidence synthesis was used to summarize the results.

Results

Eleven studies were identified for inclusion, which suggested a lack of literature in the field. Best evidence analysis identified strong evidence for an association between being married/living with someone and reduced risk of osteoporotic fracture. Limited evidence exists of the relationship between occupation type or employment status and fracture, or for type of residence and fracture. Conflicting evidence exists for the relationship between osteoporotic fracture and level of income and education.

Conclusion

Limited good quality evidence exists of the role SES might play in osteoporotic fracture. Further research is required to identify whether a relationship exists, and to elucidate underlying mechanisms, as a necessary precursor to considering intervention implications.

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Acknowledgements

The authors would like to thank Alison Beauchamp for providing information on the effectiveness of interventions for cardiovascular disease in socially disadvantaged groups.

Funding

Ms Brennan is supported by a National Health and Medical Research Council (NHMRC) PhD scholarship (519404). Associate Professor Pasco and Dr Wluka are the recipients of NHMRC Project Grant (436665). Dr Hanna, Dr Urquhart, and Dr Wluka are the recipients of NHMRC Public Health and Clinical Fellowships (418961, 284402 and 317840).

Conflicts of interest

None.

Disclaimers

The author(s) declare there are no competing interests.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia

    S. L. Brennan, D. M. Urquhart & B. Oldenburg

  2. Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Geelong, Australia

    J. A. Pasco

  3. Department of Epidemiology and Preventive Medicine, Monash University; Baker IDI Heart and Diabetes Institute, Melbourne, Australia

    F. Hanna & A. E. Wluka

  4. Department of Epidemiology and Preventive Medicine, Monash University—Central and Eastern Clinical School, The Alfred Hospital, Commercial Road, Melbourne, 3004, Victoria, Australia

    A. E. Wluka

Authors
  1. S. L. Brennan
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  2. J. A. Pasco
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  3. D. M. Urquhart
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  4. B. Oldenburg
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  5. F. Hanna
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  6. A. E. Wluka
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Corresponding author

Correspondence to A. E. Wluka.

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Brennan, S.L., Pasco, J.A., Urquhart, D.M. et al. The association between socioeconomic status and osteoporotic fracture in population-based adults: a systematic review. Osteoporos Int 20, 1487–1497 (2009). https://doi.org/10.1007/s00198-008-0822-9

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  • DOI: https://doi.org/10.1007/s00198-008-0822-9

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