Relationship between social determinants of health and hip fracture in the American population: a cross-sectional NHANES study.

Abstract

This article aims to investigate the link between social determinants of health (SDoH) and the occurrence of hip fractures, and to analyze the potential underlying mechanisms of influence. This paper conducted a deep analysis among the general sample population from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Within each survey period, self-reported data covering eight domains of SDoH were collected, including employment status, poverty-to-income ratio (PIR), food security, educational level, health insurance coverage, type of health insurance, homeownership, and marital status. Concurrently, a history of hip fractures among participants was learned through self-reporting. Correlation analysis, Lasso regression analysis, and the Boruta algorithm were employed to explore the link between SDoH and hip fractures. This study comprehensively analyzed 11,254 adult participants. The findings indicated a notable link between eight sub-items of SDoH and the risk of hip fracture. Specifically, the cumulative number of adverse SDoH was positively linked with the risk of hip fracture. Especially as 4-7 adverse factors were accumulated, the incidence of hip fractures climbed greatly. This paper suggests a marked link between adverse SDoH and the occurrence of hip fractures, particularly when these adverse factors accumulate to a certain number (4-7). A profound probe into the interactions among these SDoH and their mechanisms of influence on fracture risk may offer crucial evidence for the prevention and intervention of hip fractures.