Background
While national guidelines for screening bone mineral density (BMD) testing do not make distinctions based on race or ethnicity, providers often consider African Americans at low risk for osteoporosis. Multifactorial racial disparities have been identified in a number of areas in clinical medicine, but no data are available on relative frequency of osteoporosis screening among races. To examine the potential for racial disparity in screening, we assessed the racial distribution in DEXA screening rates among African American and Caucasian women referred from our primary care clinics.
Methods
We obtained DEXA results during the years 1998-2002 for all 546 women age 50 years and over, referred for BMD testing from a primary care population base of approximately 8,300 women in this age group at the academic medical center. Medical records were abstracted for demographic characteristics, risk factors for osteoporosis, and DEXA results. The race and age distribution of screened women was compared with that of the clinic population. Risk factors for osteoporosis and DEXA results were also compared by race and age.
Results
Although African-American women over the age of 50 years represent approximately 50% of our primary care clinic population in this age group, only 14.5% (n=79) of the screened women were African-American, while 82.8% (n=452) were Caucasian and 2.7% (n=15) other races. Comparing African-Americans and Caucasian women, the prevalence of osteoporosis in those screened was 21.5.0% and 20.1% (p= 0.778) and for osteopenia 36.7 % and 39.4 % (p= .653) respectively. African-American women who were screened were significantly older (4.5 years, p<.001) and had a larger BMI (31.4 vs. 27.9, p<.001). The presence of recognized risk factors for osteoporosis did not explain the difference in screening rates or the age difference between African American and Caucasian women.
Conclusion
The large discrepancy between the proportion of African American and Caucasian women screened, the later age at the time of screening, and the similar osteoporosis rates among those screened, reflect complex interactions that require further study.
Disclosure Information:
Faculty Member's Name: Irene Hamrick, MD
I have no relationships to disclose.
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