In a recent interview with Physician’s Weekly, Dr. Rajesh K. Jain discussed findings from a comprehensive review published in the Journal of Clinical Endocrinology and Metabolism, revealing how race and ethnicity significantly influence osteoporosis diagnosis, treatment, and outcomes in the United States.
“Race and ethnicity are a key part of osteoporosis diagnosis and management,” Dr. Jain said, yet they remain underrepresented in clinical guidelines. The review found that Black women are less likely to receive bone density tests or treatment, and Black and Asian patients often face delays in surgery after hip fractures. Black and Hispanic individuals also experience poorer functional outcomes and are less likely to be referred to rehabilitation.
Interestingly, Asian, Black, and Hispanic people are less likely to fracture than White individuals, and some studies show superior bone structure in Black and Asian patients. However, these advantages do not translate into better outcomes. Fracture risk calculators like FRAX often fail to accurately predict fractures in minority populations, prompting the authors to recommend lower treatment thresholds for these groups.
Asian patients, in particular, face a sixfold increased risk of atypical femur fractures from common osteoporosis medications. Dr. Jain advises considering drug holidays and exploring anabolic therapies for high-risk Asian patients.
He emphasized that “if a person’s race can improve the care a physician provides, it should be used just like any other patient information.” Future research should focus on refining fracture risk tools to better serve diverse populations.
See: “Q&A: Incorporating Race & Ethnicity in Osteoporosis Treatment” (October 14, 2025)
