Osteoporosis is now a significant public health issue in the United States. In the special J. Robert Gladden Society supplement of the Journal of the American Academy of Orthopaedic Surgeons, Patricia A. Thomas, MD, a professor of pathology and laboratory medicine at the University of Kansas, School of Medicine, reviewed the racial and ethic differences in osteoporosis for women.

"Osteoporosis tops the list of important public health concerns," said Dr. Thomas, "because of the significant morbidity and mortality associated with osteoporotic fracture-specifically, hip fractures."

According to national statistics following a hip fracture:

- 20 percent of women die within one year
- 20 percent become permanently disabled
- More women will die of hip fractures nationally than will die of breast cancer.
- In the U.S. hip fractures cost 18 billion dollars a year in hospital care expenditures.

Approximately 20 percent of non-Hispanic white and Asian women aged 50 years and older have osteoporosis, compared with five to 10 percent of non-Hispanic black women and 10 to 15 percent of Hispanic women the same age.

"Often, unless an individual experiences a fracture, osteoporosis remains silent and undiagnosed, particularly for women in racial and ethnic minority groups in the United States," said Dr. Thomas.

Awareness of osteoporosis for minority groups is also a concern. Although an increasing number of women in the United States say they are very familiar with the disease only:

- 25 percent of African American women
- 19 percent of Hispanic American women
- 17 percent of Asian American women are, in fact, very familiar with the disease compared to:
- 41 per cent of non-Hispanic White women

The review also states that African American and Hispanic women may not be as familiar with behaviors that promote and help maintain optimal bone mass. "Of greatest importance is that minority women may suffer disproportionately poorer outcomes than their non-minority counterparts," said Dr. Thomas. Several studies point to the facts that African American women are twice as likely as white women to die within the first year after a hip fracture and are more than 1.5 times more likely to die while hospitalized for that fracture.

Dr. Thomas also said, "Every women regardless of race, ethnicity or presumed risk, should be aware of osteoporosis and the importance of prevention. It is important for all women to be familiar with the risks and know which risks are preventable. Women should be empowered to seek out this information and treatment for themselves. Health care professionals should apply culturally competent care to increase the level of care provided to all women, particularly women in racial and ethnic minority populations."

American Academy of Orthopaedic Surgeons