Effect of socioeconomic status on survival in osteoporotic women: Findings from a Taiwan nationwide cohort

Abstract

Abstract Background Osteoporosis is a recognized major threat to public health. Socioeconomic status (SES) is an important factors affecting health, and a confirmed predictor of various diseases and death. This study aimed to determine the relationship between survival and SES among osteoporotic women in Taiwan. Methods A cohort population-based study was conducted using the National Health Insurance Research Database of Taiwan from 2008 to 2013. The study subjects were women aged ≥ 50 years with osteoporosis identified from either a previously-documented diagnosis or osteoporosis-related fractures according to diagnostic codes. We designated individual SES and neighborhood SES by each patient’s job category and household income, characterizing each as advantaged or disadvantaged. Then, we compared the survival rates by SES group using Cox proportional hazards models adjusted for risk factors. Results This study included 21,546 women aged ≥ 50 years with osteoporosis. In terms of 5-year overall survival, osteoporotic patients with low individual SES living in disadvantaged neighborhoods were riskier of mortality than those with high SES living in disadvantaged neighborhoods, after adjustment for age and comorbidity. Osteoporotic women with low individual SES living in disadvantaged neighborhoods had no significant difference of mortality as those with low individual SES living in advantaged neighborhoods. Conclusions In this study, we found that individual SES, but not neighborhood SES, had worst survival rate and was associated with an increased mortality rate in osteoporotic women.