title: Risk, significance and biomedicalisation of a new population: older women's experience of osteoporosis screening.
abstract: This article explores the illness experience associated with being diagnosed at risk of a long term chronic condition and discusses the implications of an emergent form of predictive medicine. We report on findings from a study involving 30 older women between the ages of 73-85 years of age recently screened for osteoporosis and informed that they are at a higher than average risk of breaking a bone in the next 10 years, but not formally diagnosed with osteoporosis. Data were gathered by the Adherence to Osteoporosis Medicine (ATOM) study using in-depth interviews with women in their own homes in Norfolk & Suffolk, UK in 2009-2010. We analyse and discuss the significance participants give to their new fracture risk status and consider the practical, physical and existential consequences of this 'diagnosis'. The findings are discussed under three broad themes: Predictive technology, meaning and the risk-of-illness experience; knowledge, understanding and the embodiment of fracture risk status; and, social implications of biomedicine for an ageing population. We argue that screening for osteoporosis and assessment of fracture risk can be understood as a process of biomedicalisation of ageing and bone health. This article offers insight into the meaning of risk status as an illness experience for older women. We conclude by discussing how biomedicalisation of a new population through diagnosis of fracture risk status has significance and consequence at both the individual and the societal level expanding the population of older women labelled at risk and increasing demand for biomedical tests and prescribed medication for the prevention of disease.
authors.affiliation: Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Chancellors Drive, Norwich, Norfolk NR4 7JJ, United Kingdom. c.salter@uea.ac.uk
authors.forename: Charlotte Ingrid
authors.initials: CI
authors.lastname: Salter
authors.forename: Amanda
authors.initials: A
authors.lastname: Howe
authors.forename: Lisa
authors.initials: L
authors.lastname: McDaid
authors.forename: Jeanette
authors.initials: J
authors.lastname: Blacklock
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lenaghan
authors.forename: Lee
authors.initials: L
authors.lastname: Shepstone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D020811:Biomedical Technology; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008403:Mass Screening / Q000379:methods*; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D012307:Risk Factors; D012962:Sociology, Medical