Importance of Bone Health as a Public Health Issue

Bone health is a pressing issue in America and around the world. It needs to be addressed with a preventive approach with the early institution of interventions. There is a need for healthcare providers to understand the importance of bone health as a public health issue. The goal is to promote strong bones in the American population so that fractures and their associated complications can be prevented. In this article we provide a brief overview of how bone health is an important public health issue.

Our bone densitometry course has comprehensive information on the importance of bone health. This course is worth 23 ARRT^® CE* credits and satisfies both general radiography and DXA CE credit requirements in all 50 states.

Bone Health: A Public Health Issue

Bones constitute the framework that allows the body to move and protects it from injury. Healthy bones are critical to the overall health and wellbeing of a person. Many life-sustaining physiologic processes in the body are dependent on the minerals which are stored in bones. If bone health is less than optimal, it can lead to fractures and poor execution of functions in the body that depend on bones, directly or indirectly.

In the United States, the importance of bone health is not completely understood and this aspect of healthcare is in increasing jeopardy. If left unaddressed, the problem could worsen, especially as the population of older Americans increases. It is estimated that every year approximately 1.5 million people suffer from a fracture related to osteoporosis. Several organizations are working to remedy this, including the National Bone Health Alliance.

There is substantial information available about the prevention of bone diseases and the importance of bone health. The assessment, diagnosis, and treatment of many bone conditions is well documented. The bone health of American citizens can be greatly improved by applying this available knowledge in a timely fashion. Unfortunately, although much has been learned about bone health, the use of this knowledge has been less than adequate. Public awareness and the practical application of this knowledge by healthcare professionals are both suboptimal.

Bone Health: At-Risk Populations

Of particular concern are racial minorities, ethnic groups, and other underserved citizens. This includes people who live in rural areas with limited access to healthcare or people who are uninsured or inadequately insured. Keeping in mind the importance of bone health, a public health approach to bone health must include strategies to close these gaps. Programs that are specifically geared towards underserved populations will result in the overall improvement of bone health in America. The need is for the government (federal, state, and local) to join hands with community organizations as well as the private sector for a collaborative and coordinated effort to promote healthy bones in the American people. Some efforts have been made in this direction, but a lot of work still needs to be done.

Bone Health: What Is Most Important?

The last few decades, particularly the last two decades, have seen immense progress in our understanding of bones and the diseases that afflict them. Research has enabled the medical community to understand bone health in much greater detail than previously. There is improved knowledge of factors that cause bone diseases and fractures as well as factors that promote healthy bones. This has led to considerable advances in disease prevention, assessment of risk factors, diagnosis, and treatment of bone diseases. All this has led to a better understanding of the importance of bone health.

It is now well known that in people of all ages, calcium and vitamin D along with regular physical activity are vital contributors to good bone health. It is also well understood that although bone disease is more prevalent in the later stages of life, early prevention and a lifelong commitment to bone-healthy habits, beginning at a very young age, is important.

Importance of Bone Health Monitoring

With the increasing understanding of predisposing risk factors, there have been major advances in the development of tools to assess an individual’s likelihood of developing bone disease. Once high-risk individuals have been identified with these risk-assessment tools, these individuals can be subjected to closer monitoring, further evaluation, and intervention if needed.

In the last 25 years, one of the most significant advances in bone health has been the development of tools for the prevention and diagnosis of bone disease. It is possible to measure a person’s bone mass and bone density in a noninvasive manner. This has made it possible to identify individuals who are at an unusually high risk of fractures and institute preventative measures. These tools also make the early detection of bone disease possible.

Treatment Options for Bone Diseases

In addition to an increased understanding of the importance of bone health, there have been considerable advances in therapy. Large randomized trials have demonstrated that new classes of drugs, developed in the last couple of decades, are able to significantly reduce fracture risk in high-risk individuals. Research has also confirmed that calcium and vitamin D supplementation is a valuable method of reducing the risk of fractures, especially in high-risk populations.

The medical community now has a much better understanding of the secondary factors that affect an individual’s bone health. These factors include certain co-existing diseases or the use of some drugs associated with bone loss. For instance, it is known that glucocorticoid medications contribute significantly to osteoporosis. This understanding has ensured that physicians carefully evaluate a patient’s need for these medications. In people who absolutely need treatment with potential osteoporosis-inducing medications, interventions are undertaken to minimize the risk.

Similarly, there is greater knowledge about why elderly people are more prone to fractures. It is known that this population is more prone to falls and that weak, elderly bones are more likely to fracture. This enhanced understanding allows healthcare professionals to study the underlying reasons that cause falls. In turns, this allows the implementation of interventions that prevent falls. Fall prevention interventions include avoiding medications that cause dizziness as a side effect, modifying the homes of elderly persons, and improving balance and strength with physical therapy.

Bone Health in the Future

There is no doubt that there has been tremendous progress in understanding the importance of bone health in the last few decades. Only three decades ago, osteoporosis was a relatively poorly understood condition. It was assumed that osteoporosis and its associated fragility fractures were an unavoidable part of the normal aging process. Now, scientific advances have ushered in an era of prevention, early detection, and effective treatment for the disease.

Nonetheless, the enormous potential offered by new research and in-depth knowledge has not been fully utilized. Many bone diseases, such as osteoporosis, hyperparathyroidism, rickets, osteogenesis imperfecta, osteomalacia, and renal osteodystrophy, are still major public health concerns. More than 10 million Americans are afflicted by bone disease each year, and unless prompt action is taken, this figure is set to rise dramatically in the coming decades. The 1.5 million fractures that bone diseases cause each year result in immense physical, emotional, and financial costs to the patient, family, and society at large.

Bone Health: What Needs to be Done?

Much is already understood about the prevention, diagnosis, and treatment of bone conditions and many of these costs are completely avoidable. Failure to apply available knowledge by healthcare providers and a lack of awareness in the general public has resulted in suboptimal reduction in the immense burden of bone disease. This is of utmost significance in understanding the importance of bone health.

It is of grave concern that in addition to the general population, some members of the medical community continue to believe that osteoporosis is the natural outcome of aging and nothing can be done to prevent or treat it. Until such views are corrected, our enhanced understanding of bone health will remain underutilized. The general public needs to be made aware of the importance of bone health and its considerable impact on an individual’s overall quality of life. The medical community must focus on early prevention, timely diagnosis, and effective treatment of bone diseases and fractures in individuals of all age groups.

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