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Racial Disparities in the Receipt of Osteoporosis Related Healthcare Among Community-Dwelling Older Women with Arthritis and Previous Fracture
TED R. MIKULS, KENNETH G. SAAG, VARGHESE GEORGE, AMY S. MUDANO, and SAMPRIT BANERJEE
ABSTRACT.
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. (J Rheumatol 2005;32:870-5) Key Indexing Terms:
RACE
From the Department of Medicine, Section of Rheumatology and Immunology, University of Nebraska Medical Center, Omaha, Nebraska; Omaha VA Medical Center, Omaha, Nebraska; Department of Medicine, Division of Clinical Immunology and Rheumatology; Center for Education and Research for Therapeutics (CERTs) in Musculoskeletal Disorders; and Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA. Supported by an unrestricted educational grant from Pfizer, Inc. Dr. Mikuls receives support from NIH/NIAMS (1 K23 AR0500004-01A1), the Arthritis Foundation (Arthritis Investigator Award), and the Nebraska Chapter of the Arthritis Foundation. Dr. Saag is the Director of the UAB Center for Education and Research on Therapeutics of Musculoskeletal Disorders (AHRQ grant U18 HS 10389). T.R. Mikuls, MD, MSPH, Assistant Professor, Department of Medicine, University of Nebraska Medical Center, Omaha VA Medical Center; K.G. Saag, MD, MSc, Associate Professor; A.S. Mudano, MPH, Department of Medicine, Center for Education and Research for Therapeutics in Musculoskeletal Disorders, University of Alabama at Birmingham; V. George, PhD, Assistant Professor, Department of Medicine, Department of Biostatistics, University of Alabama at Birmingham; S. Banerjee, MSc, Department of Biostatistics, University of Alabama at Birmingham. Address reprint requests to Dr. T.R. Mikuls, Section of Rheumatology, University of Nebraska Medical Center, 983025 Nebraska Medical Center, Omaha, NE 68198-3025. E-mail: tmikuls@unmc.edu Accepted for publication December 23, 2004. |