Racial disparities in the receipt of osteoporosis related healthcare among community-dwelling older women with arthritis and previous fracture

Objective. To examine potential racial/ethnic disparities in osteoporosis care among community-dwelling older women with self-reported arthritis and previous fracture. Methods. We conducted a computer assisted telephone interview using a population based random sample drawn from 6 counties in Alabama, USA. Eligible respondents had self-reported arthritis and were over 50 years of age; 1424 people responded to the survey. Logistic regression was used to examine the association of race/ethnicity with the receipt of dual energy x-ray absorptiometry (DEXA) and prescription osteoporosis treatments (including bisphosphonates, calcitonin, hormone replacement, or selective estrogen receptor modulators) among older women with a history of fracture. Results. Of eligible African American and Caucasian female respondents, 251 (25%) reported a history of fracture after 45 years of age. Women with a history of self-reported fracture were predominantly Caucasian (n = 178, 71%) and had a mean age of 68 ± 11 years. After multivariable adjustment, African American women with a fracture history were less likely than Caucasian women with a history of fracture to receive a DEXA (OR 0.39, 95% CI 0.19-0.81) or prescription osteoporosis medicines (OR 0.17, 95% CI 0.08-0.37). Conclusion. In this population of community-dwelling older women, African American respondents at high risk for fracture were far less likely than Caucasians to receive osteoporosis related healthcare.