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SMJ // Article

Original Article

Osteoporosis Preventive Care in White and Black Women in Community Family Medicine Settings

Authors: Margaret L. Gourlay, MD, MPH, Leigh F. Callahan, PhD, John S. Preisser, PhD, Philip D. Sloane, MD, MPH

Abstract

Background: Osteoporosis has been studied predominantly in white postmenopausal women.


Materials and Methods: We performed a cross-sectional survey of a random sample of 400 women aged 45 years and older enrolled in a family medicine community-based research network. Participants responded to 42 items regarding osteoporosis screening and prevention during primary care visits. Odds ratios were calculated comparing black versus white women, adjusting for age, weight, fracture history, family history of osteoporosis, and practice site.


Results: Compared with black women, white women had 5.96 (95% CI 3.01, 11.79) times the adjusted odds of having a past bone density test, 2.97 (95% CI 1.57, 5.60) times the odds of discussing osteoporosis with their doctor, and 2.42 (95% CI 1.30, 4.50) times the odds of a physician recommendation to take calcium.


Conclusions: Disparities in osteoporosis preventive care were found between black and white women, after adjustment for other osteoporosis risk factors.


Key Points


* Equivalent proportions (about half) of black and white women considered discussion of osteoporosis with their primary care providers to be “very important.”


* Compared to white women, black women had significantly lower rates of bone density testing, counseling, and prescriptions for osteoporosis-related medications.


* White race was more strongly associated with bone density testing, calcium prescriptions and discussions about osteoporosis than any other osteoporosis risk factor.

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