Epidemiology of bone fracture across the age span in blacks and whites.

BACKGROUND: Gender and racial disparities in injury mortality have been well established, but less is known regarding differences in fracture-related hospitalizations across the age span. METHODS: Cross-sectional analysis of annual incident fracture hospital admissions used statewide acute care hospital discharge data (Statewide Program and Research Cooperative System) for non-Hispanic White (n = 138,763) and non-Hispanic Black (n = 19,588) residents of New York State between 2000 and 2002. US census data with intercensal estimates were used to ascertain the population at risk. Gender- and race-specific incident fracture was calculated in 5-year age intervals. The χ test was used to analyze categorical variables. RESULTS: Mechanisms of injury vary by race and gender in their relative contribution to injury-related fractures across the age span. Black males exhibited higher fracture incidence until approximately age 62, while incidence in women diverged around age 45. Total motor vehicle traffic-related fracture hospitalization is bimodal in Whites but not in Blacks. Over the life span, all groups exhibited bimodal pedestrian fractures with pedestrian fractures accounting for 8.8% and 2.5% of all fractures in Blacks and Whites, respectively. Racial disparities were present from preschool through age 70. Violence-related fractures were 10 times higher in Blacks, accounting for 18.2% of hospitalizations. Black males exhibit higher fracture incidence due to violence by age 5 and higher gun violence by age 10; both remain elevated through age 75. CONCLUSIONS: Despite historical studies demonstrating higher bone density in Blacks, this study found racial disparities with increased fracture risk in both Black children and adults across most nonfall-related injury mechanisms examined.