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Disparities in osteoporosis care among postmenopausal women in the United States

      Highlights

      • In the United States, there is limited screening of women aged 65 years or more for osteoporosis.
      • Significant racial/ethnic disparities exist in the diagnosis and treatment of osteoporosis; systems-, provider-, and patient-level factors contribute to these disparities.
      • The current fracture risk calculators were primarily validated in white populations, making their generalizability to racial/ethnic minority populations unclear.

      Abstract

      Osteoporosis and fragility fractures result in significant morbidity and mortality and contribute to substantial healthcare costs. Despite being a treatable disease, osteoporosis remains both underdiagnosed and undertreated in the US general population, with significant disparities in care between non-White and White women. These disparities are evident from screening to post-fracture treatment. Non-White women are less likely to be screened for osteoporosis, to be prescribed pharmacotherapy, or to receive treatment post-fracture; furthermore, the mortality rate after fracture is higher in non-White women. Given existing diagnostic and treatment disparities, additional studies and interventions are needed to optimize the bone health of Asian, Black, Hispanic, and Native American women, and to reduce morbidity and mortality from osteoporosis and fragility fractures.

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