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Does inadequate diet during childhood explain the higher high fracture rates in the Southern United States?
Paulozzi LJ – Findings suggest that inadequate nutrition during skeletal formation early in life might explain the higher incidence of hip fracture among older adults in the Southern states of US.

Methods
  • Study was led by speculation that state of residence early in life is a better predictor of the risk of hip fracture after age 65 than state of current residence
  • Geography of rickets mortality in the US before 1950 was compared with the geography of hip fracture rates among older adults during 1986–1993
  • Vital statistics data for the US white population for 1942–1948 allowed calculation of the ratio of deaths from rickets to live births for each geographic division of US
  • These ratios were correlated with previously published, standardized hip fracture rates among whites 65–89 yrs old during 1986–1993 by census division
Results
  • During 1942–1948, the rickets mortality ratio among whites was 3.11 in the South, 1.91 in the Northeast, 1.75 in the Midwest, and 1.04 in the West
  • The correlation of mortality with risk of hip fracture was 0.71 for both sexes combined and 0.86 for women
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