Social deprivation as a risk factor for fractures in childhood

Abstract

Paediatric fractures are common and can cause significant morbidity. Socioeconomic deprivation is associated with an increased incidence of fractures in both adults and children, but little is known about the epidemiology of paediatric fractures. In this study we investigated the effect of social deprivation on the epidemiology of paediatric fractures. We compiled a prospective database of all fractures in children aged < 16 years presenting to the study centre. Demographics, type of fracture, mode of injury and postcode were recorded. Socioeconomic status quintiles were assigned for each child using the Scottish Index for Multiple Deprivation (SIMD). We found a correlation between increasing deprivation and the incidence of fractures (r = 1.00, p < 0.001). In the most deprived group the incidence was 2420/100 000/yr, which diminished to 1775/100 000/yr in the least deprived group. The most deprived children were more likely to suffer a fracture as a result of a fall (odds ratio (OR) = 1.5, p < 0.0001), blunt trauma (OR = 1.5, p = 0.026) or a road traffic accident (OR = 2.7, p < 0.0001) than the least deprived. These findings have important implications for public health and preventative measures.

Socioeconomic Deprivation and Its Adverse Association with Adolescent Fracture Care Compliance

“…Within orthopaedic surgery, numerous studies have analyzed the relationship between socioeconomic deprivation and fracture incidence in adults, noting that individuals from more deprived regions are at a higher risk for fracture 16 - 20 . There is a similar relationship between social deprivation and fracture risk in adolescents, including the humerus, the distal part of the radius, or hand fractures 21 - 23 .…”

Ethnic and geographic variations in the epidemiology of childhood fractures in the United Kingdom

“…[2] Furthermore, there is evidence from some, but not all studies,[3] to suggest that sustaining a fracture in childhood is associated with lower indices of bone strength[4] and an increased risk of fracture in adulthood. [5] Previous studies have found considerable variation in incidence rates of childhood fracture across European countries, ranging from 120 to 361 per 10,000 person years (Table 1) [1, 6-17], although recent epidemiological studies from Scandinavia have suggested that overall childhood fracture incidence increased from the mid to late 20 th century and has been followed by a more recent plateau or decline. [6, 8, 15] It is well recognised that childhood fractures are more common in boys than girls [12], and peak in incidence during the puberty [12], however, there are few published data pertaining to geographic or ethnic variation in fracture rates within a single country.…”

Epidemiological characteristics of pediatrics fracture at tertiary care hospital, Malaysia

“…7,8 In our study, we described fracture distribution, mechanism of injuries and their differences in distinct age groups and gender among the paediatric population. The observation suggested that there was an overall predominance of males over females with the ratio of 2:1 and was highest among the school going children.…”