{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T23:03:51Z","timestamp":1776726231413,"version":"3.51.2"},"reference-count":46,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2015,12,24]]},"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Socioeconomic factors may influence changes in hip fracture (HF) incidence over time. We analysed HF temporal trends during the Bone and Joint Decade in Portugal (BJD-Portugal), 2000\u20132010, by regional socioeconomic status (SES), sex and age.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We selected registers of patients aged 50+ years with HF (International Classification of Diseases, V.9\u2014Clinical Modification, ICD9-CM) caused by traumas of low\/moderate energy, from the National Hospital Discharge Database. Annual time series of age-specific incidence rates were calculated by sex and regional SES (deprived, medium, affluent). Generalised additive models were fitted to identify shape\/turning points in temporal trends.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We selected 96\u2005905 HF (77.3% in women). Women were older than men at admission (81.2\u00b18.5 vs 78.2\u00b110.1\u2005years-old, p&lt;0.001). For women 65\u201379\u2005years, a continuously decreasing trend (1.7%\/year) only in affluent and increasing trends (3.3\u20133.4%\/year) after 2006\/2007 in medium and deprived was observed. For men, trends were stable or increased in almost all age\/SES groups (only two decreasing periods). For the oldest women, all SES present similar trends: turning points around 2003 (initiating decreasing periods: 1.8\u20132.9%\/year) and around 2007 (initiating increasing periods: 3.7\u20133.3%\/year).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There were SES-sex-age inequalities in temporal trends during BJD-Portugal: marked SES inequalities among women aged 65\u201379\u2005years (a persistent, decreasing trend only in the affluent) vanished among the oldest women; the same was not observed in men, for them, there were almost no declining periods; women aged \u226580\u2005years, presented increasing trends around 2007, as in most deprived\/age\/sex groups. Despite some successful periods of decreasing trends, incidence rates did not improve overall in almost all age groups and both sexes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech-2015-206508","type":"journal-article","created":{"date-parts":[[2016,1,19]],"date-time":"2016-01-19T21:29:47Z","timestamp":1453238987000},"page":"755-763","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Marked socioeconomic inequalities in hip fracture incidence rates during the Bone and Joint Decade (2000\u20132010) in Portugal: age and sex temporal trends in a population based study"],"prefix":"10.1136","volume":"70","author":[{"given":"Carla Maria","family":"Oliveira","sequence":"first","affiliation":[{"name":"i3S\u2014Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, Universidade do Porto, Porto, Portugal"},{"name":"INEB\u2014Instituto de Engenharia Biom\u00e9dica, Universidade do Porto, Porto, Portugal"},{"name":"ESTSP\/IPP\u2014Escola Superior de Tecnologia da Sa\u00fade do Porto, Instituto Polit\u00e9cnico do Porto, Vila Nova de Gaia, Portugal"},{"name":"FMUP\u2014Faculdade de Medicina da Universidade do Porto, Porto, Portugal"},{"name":"ISPUP\u2014Instituto de Sa\u00fade P\u00fablica da Universidade do Porto, Porto, Portugal"}]},{"given":"Sandra Maria","family":"Alves","sequence":"additional","affiliation":[{"name":"i3S\u2014Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, Universidade do Porto, Porto, Portugal"},{"name":"INEB\u2014Instituto de Engenharia Biom\u00e9dica, Universidade do Porto, Porto, Portugal"},{"name":"ESTSP\/IPP\u2014Escola Superior de Tecnologia da Sa\u00fade do Porto, Instituto Polit\u00e9cnico do Porto, Vila Nova de Gaia, Portugal"}]},{"given":"Maria F\u00e1tima","family":"Pina","sequence":"additional","affiliation":[{"name":"i3S\u2014Instituto de Investiga\u00e7\u00e3o e Inova\u00e7\u00e3o em Sa\u00fade, Universidade do Porto, Porto, Portugal"},{"name":"INEB\u2014Instituto de Engenharia Biom\u00e9dica, Universidade do Porto, Porto, Portugal"},{"name":"FMUP\u2014Faculdade de Medicina da Universidade do Porto, Porto, Portugal"},{"name":"ICICT\/FIOCRUZ\u2014Instituto de Comunica\u00e7\u00e3o e Informa\u00e7\u00e3o em Sa\u00fade\/Funda\u00e7\u00e3o Oswaldo Cruz, Rio de Janeiro, Brazil"},{"name":"CARTO-FEN\/UERJ\u2014Departamento de Engenharia Cartogr\u00e1fica, Faculdade de Engenharia da Universidade do Estado do Rio de Janeiro. 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