Osteoporosis is a common bone disease in the United States. It affects over 10 million United States adults. The disease is an age-related disease that causes the bones to become thin and fragile, resulting in increased risk for fractures. The condition is considered the leading cause of fractures in the United States. Such fractures often lead to disability, rendering the quality of life of the victims poor. It is also important to note that over 34 million other Americans suffer from a low bone mass. Such people with low bone mass are generally at risk for developing fractures, as well as osteoporosis.
Osteoporosis also has considerable economic impacts on the population. The total medical cost attributed to the condition is very high. For instance, the total cost of osteoporosis and fractures treatment among older United States citizens aged 65 years and above, was estimated to be $22 billion in 2008. This indicates that osteoporosis along with related health problems have taken a toll on the economic lives of Americans, particularly those in Los Angeles.
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According to the Los Angeles County Health Survey of 2011, about 18 percent of adults who are aged 65 years and above stated that they had been diagnosed with osteoporosis. These data suggest that the number of people who have osteoporosis is likely to increase in the future, as the population in Los Angeles County ages. As such, the percentage of the adult population with the condition is set to grow considerably. It is estimated that 76 million United States adults will be affected by osteoporosis by 2030. These figures indicate that the condition will significantly affect the quality of life of adult Americans, particularly those in Los Angeles County (Gase et al., 2015). Thus, health policymakers in Los Angeles County should take the necessary measures to assess and address the prevalence and impact of osteoporosis in the population.
Osteoporosis in Los Angeles County
A significant proportion of the Los Angeles County population, aged 65 years and older, has reported having diagnosed with osteoporosis. More specifically, about 18 percent of this population segment has been directly affected by osteoporosis (LACHS 2011). Generally, this disease affects both men and women. However, there is always a greater focus on osteoporosis in women compared to their male counterparts (Barack et al., 2014). Such is the case because there is generally higher prevalence and fracture burden on women. Studies have shown that 1 in 2 post-menopausal women and 1 in 5 men over the age of fifty will suffer from osteoporosis-related fractures. It is, however, important to note that the hip fractures that occur in men often lead to higher mortality. Unfortunately, osteoporosis is a bone disease that has increasingly continued to be underdiagnosed in both genders.
The prevalence of osteoporosis is four times higher in women than in men. As such, many women have the condition compared to men. The prevalence of osteoporosis was highest among the Asians and lowest among the African Americans as shown in the statistics of Los Angeles County. Thus, African Americans are less affected as compared to other racial groups in Los Angeles County. Among the women in the county, Asians/Pacific Islanders had the highest rate of osteoporosis, followed by whites, then Latinas, and lastly African Americans. Besides, the prevalence of osteoporosis was shown to be higher among adults in Los Angeles County with generally lower levels of education. This fact could suggest that well-educated individuals are less likely to suffer from the condition.
Adults who have osteoporosis in the county have poorer health-related quality of life. Osteoporosis is usually asymptomatic. However, the fractures resulting from it can have significant negative implications on the functions and quality of life. Adult citizens who have osteoporosis are more likely to suffer from a disability. According to the 2011 Los Angeles County Health Survey, the older adults who had been diagnosed with osteoporosis were more likely to report having a particular disability, compared to adults without the health condition. Moreover, adults who have osteoporosis are generally more likely to perceive their health as being more miserable than those of adults without osteoporosis in the county.
Risk Factors for Osteoporosis
Usually, the problem of osteoporosis becomes more common especially after age 65. Although both genders are affected, women are at a much higher risk of suffering from the bone disease. For instance, women, particularly those at the postmenopausal stage are at an increased risk of suffering from osteoporosis. This phenomenon is commonly attributed to the loss of estrogen, which accelerates bone loss. On the other hand, several secondary causes of osteoporosis are more common among men, such as cigarette smoking, alcohol intake, and certain medications.
Current Efforts Aimed at Addressing Osteoporosis
Numerous campaigns have been carried out in the county. The campaigns focus on increasing the awareness that osteoporosis can be prevented through a variety of strategies. Adequate intake of vitamin D and calcium, as well as regular physical activity, are considered effective in maintaining or improving the density of bones. Thus, an emphasis has been placed on the importance of regular physical activity in both the pre-teen and teenage years. Daily physical activity has been shown to help in building increase bone mass. Physical activity also assists individuals in reducing the overall risk of developing osteoporosis later in their lives (Siris et al., 2014). While calcium intake helps to prevent or treat bone loss, intake of vitamin D is critical for calcium absorption. Studies have also indicated that intake of vitamin D could significantly help in preventing falls in older adults, particularly those who are low in vitamin D ( van Ballegooijen et al., 2015 ). Vitamin D can also reduce bone fractures among adults.
Osteoporosis screening, early diagnosis, and treatment are some of the additional preventive measures adopted for tackling the disease. It is always important to follow the recommended screening guidelines. This is because there are typically no clinical signs of osteoporosis until when a fracture occurs. For instance, 72.9 percent of women in Los Angeles County, aged 65 years and older, reported having been screened for osteoporosis. However, the screening rates differ across ethnicities, with the rates being highest among whites, and lowest among African Americans.
Discussion
Osteoporosis poses a significant health threat to Los Angeles County. It is a severe chronic condition that impacts health-related quality of life significantly. More and more people will be at risk of developing the disease, particularly as the population ages. It is important to realize that the disease affects the economic lives of those affected negatively. Early screening for the disease is an important preventive measure. Although the prevalence rate is lowest among African Americans, they are the least screened for osteoporosis. There are therapies available for those already suffering from the chronic disease.
Recommendations
For Individuals
Maintain physical activity based on the CDC recommendations, which comprise muscle strengthening and weight-bearing exercises.
Always assure a healthy diet rich in calcium and Vitamin D.
Avoid cigarette smoking and alcohol intake.
For Healthcare Providers
Prescribe appropriate medications for individuals diagnosed with osteoporosis.
Always substitute medications that increase the risk of fall with those that are less likely to cause falls.
Closely monitor patients who are under medications that may increase bone loss.
Advice patients on the appropriate diets.
Provide fall prevention counseling.
For Communities
Promote those activities that improve physical activity.
Create sidewalks that are generally safer to prevent falls.
Provide age-friendly and accessible public transportation systems.
Promote and support participation in evidence-based programs that promote healthy living.
References
Barrack, M. T., Gibbs, J. C., De Souza, M. J., Williams, N. I., Nichols, J. F., Rauh, M. J., & Nattiv, A. (2014). Higher Incidence of Bone Stress Injuries With Increasing Female Athlete Triad–Related Risk Factors: A Prospective Multisite Study of Exercising Girls and Women. The American journal of sports medicine , 42 (4), 949-958.
Gase, L. N., Barragan, N. C., Simon, P. A., Jackson, R. J., & Kuo, T. (2015). Public awareness of and support for infrastructure changes designed to increase walking and biking in Los Angeles County. Preventive medicine , 72 , 70-75.
Los Angeles County Health Survey – Los Angeles County Department of Public Health. (2011). http://publichealth.lacounty.gov/phcommon/public/reports/rptsbygroup.cfm?ou=ph&prog=hae&unit=ha&categoryid=133
Osteoporosis Risk Factors Los Angeles County, California, http://losangeles.networkofcare.org/pr/library/article.aspx?hwid=te7603
Siris, E. S., Adler, R., Bilezikian, J., Bolognese, M., Dawson-Hughes, B., Favus, M. J., ... & Lindsay, R. (2014). The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group. Osteoporosis international , 25 (5), 1439-1443.
Van Ballegooijen, A. J., Robinson-Cohen, C., Katz, R., Criqui, M., Budoff, M., Li, D., ... & de Boer, I. H. (2015). Vitamin D metabolites and bone mineral density: The multi-ethnic study of atherosclerosis. Bone , 78 , 186-193.
