Whether it is discrimination among health care professionals, mistrust of the test among African-Americans or a combination of factors, the reality is that there is a significantly lower rate of bone density screening among African-American women. This is creating a public health problem, since African-American women have higher mortality following hip fractures than Caucasian women.
At the American Geriatrics Society Annual Scientific Meeting in 2009, three doctors from Huron Hospital in Ohio presented the bone density testing rates at their hospital, surveying 402 females over the age of 65. Even among those with risk factors for osteoporosis, the screening rate among post-menopausal African-American women was less than 16%. And nearly 30% of those screened were shown to have osteoporosis. These findings are consistent with a 2006 study conducted among women at primary care clinics in the southeastern United States, which showed that over 80% of bone density tests were performed on Caucasian women while the two racial groups showed similar rates of osteoporosis (about 20%).
Both studies identify a number of factors that could account for this disparity. Doctors at Huron Hospital admit that they consider osteoporosis screening a low priority, particularly primary care physicians, who may be less aware of the risk factors or prevalence of the disease than geriatric specialists. Another issue is the misperception among some doctors that the test will not be reimbursed if patients do not have private insurance. Also of significance is the fact that both studies based their data on the actual number of women who received the bone density test, rather than the number of referrals made by doctors. The possibility remains that a number of African-American women were referred for screening and choose to have it.
Examining the root causes of poor screening rates among African-American women is crucial to eradicating osteoporosis for all populations. For more details on these studies, read:
- Louden, Kathleen. “AGS 2009: Elderly Black Women Have Low Rate of Bone-Density Screening, ” Medscape — May 05, 2009.
- HamricK, I. et al. “Health Care Disparities in Postmenopausal Women Referred for DXA Screening,” Health Services Research, 38:4, 265–269.