Regional Variation in the Incidence of Hip Fracture:  US White Women Aged 65 Years and Older

Steven J. Jacobsen, PhD; Jack Goldberg, PhD; Toni P. Miles, MD, PhD; Jacob A. Brody, MD; William Stiers, PhD; Alfred A. Rimm, PhD
JAMA. 1990;264(4):500-502. doi:10.1001/jama.1990.03450040096038.
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FRACTURE of the hip is a major cause of morbidity and mortality in persons 65 years of age and older. Incidence rates for hip fracture are known to vary by both sex and race.1-4 There is also marked variability in hip fracture incidence by geographic region, with the highest rates found in Scandinavia, followed by the United States, Western Europe, Asia, and Africa.5,6

Within the United States, relatively little is known about the geographic pattern of hip fracture. Most studies have described the incidence of hip fracture for the country as a whole,2,3 for limited geographic regions,4,7,8 or by broadly defined Census divisions.9 This study examines the geographic distribution of hip fracture incidence in the United States at the county level. To this end, data are obtained from the Health Care Financing Administration (HCFA) and the Department of Veterans Affairs (VA) that identify all hospital


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