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Racial disparities found in receipt of osteoporosis screening and management

Postmenopausal black women are two to three times less likely than postmenopausal white women to receive bone mineral density (BMD) testing to detect osteoporosis or to be prescribed osteoporosis medications. Even among women with a previous fracture, blacks still had a significantly lower likelihood of both BMD testing and prescription therapy, according to a recent study. This racial disparity was not fully explained by other demographic or risk factor differences. The study, which included a survey of more than 8,000 women, was supported in part by the Agency for Healthcare Research and Quality (HS10389) as part of the AHRQ-sponsored Centers for Education and Research on Therapeutics (CERTs) program.

Because the incidence of osteoporosis and related fractures among black women is reported to be approximately half that of white women, physicians may be inappropriately less suspicious of osteoporosis and less aggressive in its management for black women, according to the researchers who conducted the study. They examined results from an osteoporosis questionnaire mailed in April 2000, to women aged 50 or older in Alabama who were insured by a large regional managed care organization to determine their receipt of BMD testing and medical therapies for osteoporosis prevention.

Overall, 37 percent of women reported a history of fracture. Blacks had two- to three-fold lower odds of receiving BMD testing and all forms of prescription osteoporosis therapy. Differences by race were most notable for use of bisphosphonate medications (such as alendronate and risedronate). Among nonprescription therapies, white women reported significantly higher odds of using calcium and vitamin D or a multivitamin.

See "Racial disparities in osteoporosis prevention in managed care," by Amy S. Mudano, M.P.H., Linda Casebeer, Ph.D., Fausto Patino, M.D., Dr.P.H., and others, in the May 2003 Southern Medical Journal 96(5), pp. 445-451.

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