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Deprivation, urbanisation and Perthes' disease in Northern Ireland
W D Kealey1, A J Moore, S Cook
1Department of Orthopaedic Surgery, Musgrave Park Hospital, Belfast, Northern Ireland.
Insights
Perthes' disease incidence in Northern Ireland is high. This study found a link between Perthes' disease and area deprivation, but not urban living, with the highest rates in deprived rural areas.
Area of Science:
- Orthopedics
- Epidemiology
- Public Health
Background:
- Perthes' disease is a hip condition affecting children.
- Previous research suggested a higher prevalence in urban settings and with increased deprivation.
- Northern Ireland has one of the highest reported national annual incidence rates of Perthes' disease globally.
Purpose of the Study:
- To investigate the geographical distribution and risk factors for Perthes' disease in Northern Ireland.
- To examine the association between Perthes' disease incidence and settlement size (urban vs. rural).
- To assess the relationship between Perthes' disease incidence and area-level deprivation.
Main Methods:
- A preliminary analysis of Perthes' disease cases diagnosed over a seven-year period in Northern Ireland.
- Utilized 1991 census enumeration districts for spatial and non-spatial aggregation of incidence data.
- Classified cases by settlement size (urban to rural) and area deprivation levels.
Main Results:
- The incidence of Perthes' disease was significantly associated with indicators of area deprivation.
- No increased risk of Perthes' disease was observed in urban areas.
- The highest incidence rate was identified in the most deprived rural areas.
Conclusions:
- Area deprivation is a significant factor associated with Perthes' disease incidence in Northern Ireland.
- Urban location does not appear to be an independent risk factor for Perthes' disease.
- Further research into the specific environmental or socioeconomic factors in deprived rural areas is warranted.
Abstract:
It has been suggested that Perthes' disease is more prevalent in urban areas, and that the risk increases with deprivation. We present the findings of a preliminary analysis of Perthes' disease in Northern Ireland, which is shown to have one of the highest national annual rates of incidence in the world (11.6 per 100000). Of the 313 children diagnosed over a seven-year period, 311 were allocated to the enumeration districts of the 1991 census, thus allowing the incidence to be calculated using both spatial and non-spatial aggregation. The cases were grouped according to the size of the settlement from highly urbanised to open countryside and by level of area deprivation. While the incidence of Perthes' disease was found to be associated with indicators of the level of deprivation for areas, there was no evidence to suggest that there was an increased risk in urban areas; the highest rate was found in the most deprived rural category.
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