Racial disparities in the receipt of osteoporosis related healthcare among community-dwelling older women with arthritis and previous fracture.
OBJECTIVE
To examine potential racial/ethnic disparities in osteoporosis care among community-dwelling older women with self-reported arthritis and previous fracture.


METHODS
We conducted a computer assisted telephone interview using a population based random sample drawn from 6 counties in Alabama, USA. Eligible respondents had self-reported arthritis and were over 50 years of age; 1424 people responded to the survey. Logistic regression was used to examine the association of race/ethnicity with the receipt of dual energy x-ray absorptiometry (DEXA) and prescription osteoporosis treatments (including bisphosphonates, calcitonin, hormone replacement, or selective estrogen receptor modulators) among older women with a history of fracture.


RESULTS
Of eligible African American and Caucasian female respondents, 251 (25%) reported a history of fracture after 45 years of age. Women with a history of self-reported fracture were predominantly Caucasian (n = 178, 71%) and had a mean age of 68 +/- 11 years. After multivariable adjustment, African American women with a fracture history were less likely than Caucasian women with a history of fracture to receive a DEXA (OR 0.39, 95% CI 0.19-0.81) or prescription osteoporosis medicines (OR 0.17, 95% CI 0.08-0.37).


CONCLUSIONS
In this population of community-dwelling older women, African American respondents at high risk for fracture were far less likely than Caucasians to receive osteoporosis related healthcare.
Mikuls
Ted R
TR
Department of Medicine, Section of Rheumatology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska 68198-3025, USA. tmikuls@unmc.edu
Saag
Kenneth G
KG
George
Varghese
V
Mudano
Amy S
AS
Banerjee
Samprit
S
D015502:Absorptiometry, Photon; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000407:Alabama / Q000453:epidemiology; D001168:Arthritis / Q000208:ethnology*; D003625:Data Collection; D005260:Female; D050723:Fractures, Bone / Q000208:ethnology*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000208:ethnology* / Q000628:therapy*; D012044:Regression Analysis; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data*