Ethnic variation in risk for osteoporosis among women: a review of biological and behavioral factors.
Most studies of risk factors for osteoporosis and nontraumatic fracture involve white women, although more research is being geared toward bone health among various ethnic groups. The purpose of this review is to provide an overview of health disparity in osteoporosis, including assessment of bone mineral density (BMD), bone health screening, lifestyle risk factors, and treatment involving white, black, Hispanic, Asian, and Native American women. This review summarizes evidence that white, Asian, Hispanic, and Native American women are more at risk for osteoporosis than black women. These conclusions are supported by the disparity in BMD between white and black women, although the reason for this biological difference is not well characterized. Additional research is needed to determine if there is a significant difference in BMD among Hispanic, Asian, and Native American women independent of body weight and size. Similarly, there is also disparity in fracture rates, with the causes presumed to be multifactorial. Calcium intake is lower than recommended in all females at all ages; however, it is much lower in black and Native American women and highest in white and Hispanic women. Black women also have a lower vitamin D status than white women, with mean vitamin D status of Hispanic American women lying between that of black and white women. Similarly, although white women are more active than black and Hispanic women at all ages, data are lacking about physical activity habits of women of other ethnic backgrounds and how this impacts bone health. Finally, screening protocols for women of various ethnicities and effectiveness of treatments are not well established and remain a priority in women's health.
Pothiwala
Pooja
P
Department of Internal Medicine, University of Illinois, College of Medicine at Urbana, Illinois 61801, USA.
Evans
Ellen M
EM
Chapman-Novakofski
Karen M
KM
D001741:Black or African American / Q000706:statistics & numerical data; D001213:Asian / Q000706:statistics & numerical data; D015992:Body Mass Index; D015519:Bone Density; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D050723:Fractures, Bone / Q000208:ethnology; D015438:Health Behavior / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D008019:Life Style / Q000208:ethnology*; D010024:Osteoporosis / Q000208:ethnology*; D018570:Risk Assessment; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data; D016387:Women's Health / Q000208:ethnology*