Health care disparities in postmenopausal women referred for DXA screening.
BACKGROUND
Racial disparities have been identified in a number of areas in clinical medicine. Limited data are available on osteoporosis screening rates between races. We assessed the racial distribution in Dual Energy X-ray Absorptiometry (DXA) screening rates among African American and Caucasian women referred from our primary care clinics.


METHODS
We obtained DXA results during the years 1998-2002 for all 546 women ages >50 years referred for bone mineral density (BMD) testing from a primary care population. We compared the DXA screening rates between African American and Caucasian women with the racial demographics of the referring primary care clinic population.


RESULTS
African American women represented 45.9% and Caucasian women 51.7% of our primary care clinic population. Yet, only 14.5% (n=79) of the DXA screened women were African American, while 82.8% (n=452) were Caucasian. Age and recognized risk factors only explained a small portion of this difference. In women 65 years and older with universal screening recommendations, 19.4% (n=46) of the screened women were African American, and 80.6% (n=191) were Caucasian. The prevalence of osteoporosis was similar in both populations, 21.5% and 20.1% for African American and Caucasian women, respectively.


CONCLUSIONS
Significantly fewer African American women had BMD screening even though national guidelines do not differentiate by race. The large disparity between the proportion of African American and Caucasian women screened calls for more equitable BMD screening among races.
Department of Family Medicine, East Carolina University, Greenville, NC 27834, USA. hamricki@ecu.edu
Irene
I
Hamrick
Kenneth K
KK
Steinweg
Doyle M
DM
Cummings
Lauren M
LM
Whetstone
D015502:Absorptiometry, Photon / Q000706:statistics & numerical data*; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000000981:diagnostic imaging; D017698:Postmenopause; D014481:United States; D044465:White People