Does bone mineralization reflect economic conditions? An examination using a national US sample.

Background: Bone density is the most important determinant of osteoporotic fractures, which lead to significant morbidity, disability and mortality for older persons, particularly women. Sensitive periods for bone mineralization in infancy, childhood and adolescence overlap with those for height attainment. After peak density is reached in early adulthood, there is age-related decline. We ask whether bone density, as height, reflects economic conditions. Subjects and methods: Using the third National Health and Nutrition Examination Survey, a probability sample of the US population which over-sampled Blacks and Mexican Americans, we examine the associations between adult bone mineral content (BMC) adjusted for bone and body size and three economic indicators: education, height and the poverty income ratio (PIR). We compare four groups: US-born Whites, Blacks and Mexican Americans and Mexican-born Mexican Americans. Results: Education is positively associated with BMC only for White women, although there are similar, non-significant associations for Black women and White and Black men. For women, BMC is more strongly associated with height for Mexican Americans, especially the Mexican-born, than for Whites. For men, the only significant association is a negative one with education for men born in Mexico. PIR is not significantly associated with BMC, although there is pattern of lower income being associated with lower BMC for Whites and Blacks and higher BMC for Mexican Americans. Conclusion: Bone density does not reflect economic conditions as strongly or consistently as does physical stature. However, for women there is evidence that lower economic status in childhood or adolescence is associated with lower bone density. [Copyright &y& Elsevier]