Racial disparities in osteoporosis prevention in a managed care population.
BACKGROUND
Osteoporosis in black women may result in increased disability, longer hospital stays, and higher mortality compared with white women. However, it is unknown whether osteoporosis treatment or bone mineral density (BMD) measurement is different in these women, particularly in those at highest risk.


METHODS
To examine differences and determinants of osteoporosis preventive interventions among white and black women in a large regional health maintenance organization, women 50 years of age and older were surveyed (n = 8,909) to determine their receipt of BMD testing and medical therapies for osteoporosis prevention.


RESULTS
After adjusting for potential confounders, black women had two- to threefold lower odds of BMD test or osteoporosis prescription treatment. Even among women with a previous fracture, blacks still had a significantly lower likelihood of both BMD testing and prescription therapy.


CONCLUSIONS
Compared with whites, black women reported significantly less BMD testing and prescription and nonprescription osteoporosis therapy. This disparity was not fully explained by other demographic or risk factor differences.
Mudano
Amy S
AS
Department of Medicine and Center for Education and Research on Therapeutics of Musculoskeletal Disorders, Division of Continuing Medical Education, University of Alabama at Birmingham, 35294-3408, USA.
Casebeer
Linda
L
Patino
Fausto
F
Allison
Jeroan J
JJ
Weissman
Norman W
NW
Kiefe
Catarina I
CI
Person
Sharina
S
Gilbert
Donna
D
Saag
Kenneth G
KG
D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D015519:Bone Density; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control*; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data*