Osteoporotic fractures among foreign-born individuals: a national Swedish study

Research output: Contribution to journalArticle


Summary: In this national study of osteoporotic fractures in foreign-born individuals, we found a lower risk of osteoporotic fractures in general among foreign-born individuals compared with Swedish-born, especially in immigrants from southern Europe. A higher risk was found among some groups, i.e. men and women from Bosnia and Iraq and men from Lebanon. Introduction: The aim of this study was to analyse risk of osteoporotic fractures in foreign-born individuals compared with Swedish-born individuals. Methods: This was a nationwide study of individuals 50 years of age and older (N = 2,775,736). Osteoporotic fractures were defined as at least one registered diagnosis of fractures in the hip, humerus, forearm or vertebrae, in the National Patient Register between January 1, 1998, and December 31, 2012. Cox regression analysis was used to estimate the relative risk (hazard ratios (HR) with 99% confidence intervals (CI)) of incident osteoporotic fractures in foreign-born compared with Swedish-born individuals. The Cox regression models were stratified by sex and adjusted for age, comorbidities and sociodemographic status. Results: A total of 362,899 osteoporotic fractures were registered (96,847 among men and 266,052 among women), with hip fractures dominating (54.0% among men, 42.6% among women). Fully adjusted HRs (99% CI) were for all immigrant men 0.75 (99% CI, 0.73–0.78) and women 0.83 (99% CI, 0.81–0.84), with significantly lower HRs among most groups but with higher HRs in certain countries. For the specific fractures, higher HRs were found for lower forearm fractures for men from Asia and for vertebral fractures among women from Asia. Conclusions: We observed a generally lower risk of osteoporotic fractures among first-generation immigrants, with few exceptions.


External organisations
  • Karolinska Institutet
  • Icahn School of Medicine at Mount Sinai
  • Shimane University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Orthopedics
  • Public Health, Global Health, Social Medicine and Epidemiology


  • Forearm fractures, Gender, Hip fractures, Humerus fractures, Immigrants, Neighbourhood, Osteoporotic fractures, Socioeconomic status, Vertebral fractures
Original languageEnglish
JournalOsteoporosis International
Publication statusE-pub ahead of print - 2020 Aug 19
Publication categoryResearch