The Silent Epidemic: Raising Awareness on Osteoporosis and Bone Health

Osteoporosis is often referred to as a silent epidemic, and for good reason. This insidious disease can progress unnoticed until a fracture occurs, signaling the severity of bone loss that has been quietly undermining one’s skeletal strength for years. As I’ve detailed in my book, Great Bones – Taking Control of Your Osteoporosis, the statistics surrounding osteoporosis are alarming, and the impact on public health is profound. It’s crucial that we raise awareness about this condition, emphasize the importance of early diagnosis, and advocate for proactive management.

Understanding Osteoporosis: The Silent Epidemic

Osteoporosis is a metabolic bone disease characterized by low bone mass and the deterioration of bone tissue, leading to increased bone fragility and a higher risk of fractures. The disease predominantly affects individuals over the age of 50, with women being particularly susceptible. According to the National Osteoporosis Foundation, about 10 million Americans have osteoporosis, and an additional 43 million have low bone mass, putting them at risk of developing the disease.

In my book, I explain, “Osteoporosis imposes medical restrictions and physical limitations; brings pain and suffering; and may mean loss of work and an altered way of living. It can also cause premature death for the more than 10 million people age 50 and older—80 percent of them women—who have been diagnosed with this metabolic bone disease.” This statement underscores the severe and widespread impact of osteoporosis on individuals’ lives.

The Underdiagnosis Crisis

One of the most significant challenges in combating osteoporosis is its underdiagnosis. Many people are unaware that they have the disease until they suffer a fracture. This lack of awareness and early detection is a critical issue. A landmark study highlighted a disturbing trend: the percentage of American patients with a hip fracture on osteoporosis pharmacological therapy after being discharged from the hospital declined from 41 percent in 2002 to 21 percent in 2011 (Solomon, D., et al. JBMR 2014). This decline indicates that fewer patients are receiving the necessary treatment to manage their condition.

Moreover, access to diagnostic tools has decreased over time. As Medicare reimbursement for DXA scans—used to measure bone density—declined for freestanding facilities from $124 per test in 2002 to approximately $37 per test in 2015, patients in the United States and the professionals who treat them have lost almost 50 percent of their access to this critical testing (Lewiecki, M., et al., Osteoporosis International 2018). This reduction in access further exacerbates the issue of underdiagnosis.

The Impact of Osteoporosis on Public Health

The consequences of osteoporosis extend beyond individual suffering. The disease has a significant impact on public health and the healthcare system. Each year, osteoporosis causes more than 300,000 hip fractures in the United States alone. These fractures are not only painful and debilitating but also costly. The financial burden of osteoporosis-related fractures on the healthcare system is expected to exceed $25 billion annually by 2025.

Fractures due to osteoporosis are associated with increased morbidity and mortality. As I highlight in my book, “Worse, osteoporosis has a shockingly high mortality rate. Eight percent of men and 3 percent of women over the age of 50 will die while hospitalized for an osteoporosis-related fracture. According to the National Osteoporosis Foundation, 24 percent of patients age 50 and over die in the first year following a hip fracture.”

This high mortality rate underscores the severe impact osteoporosis can have, especially on older adults. Hip fractures, in particular, often lead to long-term disability and death. About one in three women and one in twelve men will break a hip in their lifetime, and the one-year mortality rate after hip fractures stands at 14 to 58 percent, depending on various factors such as age, sex, severity of the fracture, and overall health.

The Importance of Early Diagnosis and Proactive Management

Given the grave consequences of osteoporosis, early diagnosis and proactive management are crucial. Detecting osteoporosis early can significantly reduce the risk of fractures and improve the quality of life for those affected. This is where raising awareness and educating both the public and healthcare providers come into play.

Early diagnosis typically involves screening for bone density using DXA scans. These scans can identify individuals with low bone mass before they experience fractures. As I emphasize, “We need to identify patients with low bone density when they’re young so more can be done to prevent the rapid loss of bone that usually occurs later in life and increases their risk of fracture.”

In addition to early diagnosis, a comprehensive management plan is essential. This plan should include pharmacological therapies, dietary adjustments, exercise, and lifestyle changes. Medications such as bisphosphonates, hormone replacement therapy, and other FDA-approved treatments can help stabilize bone density and reduce fracture risk.

Holistic Approaches to Bone Health

While traditional pharmacological treatments are vital, integrating holistic approaches can enhance their effectiveness. A balanced diet rich in calcium, vitamin D, and other essential nutrients supports bone health. Regular weight-bearing exercises, such as walking, jogging, and resistance training, help maintain bone density and improve muscle strength, coordination, and balance.

In my practice, I advocate for a comprehensive approach that combines traditional and holistic methods. “Exercise is instrumental not only for the skeleton but also for overall health and well-being. It helps in building stronger muscles, improving balance, and enhancing cardiovascular health.”

Lifestyle changes also play a significant role in managing osteoporosis. Avoiding smoking and excessive alcohol consumption, and maintaining a healthy weight are important steps. Educating patients about the risk factors and preventive measures can empower them to take control of their bone health.

Raising Awareness and Advocating for Change

To effectively combat the silent epidemic of osteoporosis, we must raise awareness and advocate for change at both individual and systemic levels. Public health campaigns, educational initiatives, and policy changes are needed to improve access to diagnostic tools and treatment options.

Healthcare providers must be educated about the importance of early diagnosis and comprehensive management. Patients should be encouraged to discuss bone health with their doctors and to undergo regular screenings, especially if they have risk factors for osteoporosis.

In my book, I stress the need for a collaborative approach: “Armed with what you learn from this book, you’ll become a partner with your doctor in charting the course of your healthcare. The medical professional you choose should be a teammate, willing to take the time to figure things out, not treat you like a lab rat or act as a human prescription pad.”

Conclusion

Osteoporosis is a silent epidemic that poses a significant threat to public health. The underdiagnosis of the disease and the lack of proactive management contribute to its devastating impact on individuals and the healthcare system. By raising awareness, promoting early diagnosis, and advocating for comprehensive management plans that integrate both traditional and holistic approaches, we can make significant strides in combating osteoporosis.

Through education and awareness, we can empower individuals to take control of their bone health, reduce the incidence of fractures, and improve the quality of life for millions of people affected by this silent epidemic.