Osteoporosis

Osteoporosis

Osteoporosis is the selected problem. It is a metabolic bone condition characterized by reduced bone mineral density and fragile bones. Findings indicate that timely diagnoses of the condition are uncommon (Johnston & Dagar, 2020). Most diagnoses are made when patients present to the emergency department with fractured bones after falls. The population affected significantly by osteoporosis comprises older adults aged 50 years and above (Johnston & Dagar, 2020). Additionally, more incidences of the condition have been reported in females than in males (Johnston & Dagar, 2020). Osteoporosis is a problem of concern because it has economic and health impacts. Economic implications are linked to extra costs incurred from prolonged hospitalizations. On the other hand, health implications are considered holistically and include both physical, social, and psychological impacts. This paper discusses osteoporosis and evaluates its relevance to the provisions of Healthy People 2020.

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Overview, Background, and Significance of the Problem

According to Hansen et al. (2021), osteoporosis is a chronic metabolic bone condition characterized by reduced bone mineral density and fragile bones. The disease can be categorized as primary or secondary osteoporosis (Johnston & Dagar, 2020). Primary osteoporosis has the highest prevalence and can either be juvenile or idiopathic (Hansen et al., 2021). Signs and symptoms of the disease only become overt following a fracture. Fractures are accompanied by localized acute pain. Other relevant manifestations include dowager’s hump, limited range of motion, and height loss.

Various risk factors for osteoporosis have been identified. They include people aged 50 years and above, females with a small stature, deficiency of estrogens and androgens, lack of physical activity and a deficiency of calcium and vitamin D (Lin et al., 2022). Medications such as corticosteroids and insulin predispose an individual to osteoporosis (Lin et al., 2022). As aforementioned, osteoporosis has economic and health implications. The condition is associated with high morbidity rates characterized by severe pain and disability. The patient’s quality of life is lowered because they may be unable to perform some activities of daily living. Furthermore, prolonged hospitalizations due to fractures from osteoporosis are associated with an increase in treatment costs. Estimates indicate that the annual costs of managing osteoporosis will reach $25 billion (Johnston & Dagar, 2020).

Johnston and Dagar (2020) report that at least ten million people aged 50 and above have been diagnosed with osteoporosis in the USA. Additionally, at least forty-three million people have a low bone mass (Johnston & Dagar, 2020). Annual findings indicate that about 15 percent of these patients suffer fractures and that the mortality rate is about 20 percent (Johnston & Dagar, 2020). Data from 2018 reveals that about 18.8 percent of females have the condition compared to only 4.2 percent of males (Johnston & Dagar, 2020). Osteoporosis has an ethnic predisposition. Asian Americans, Hispanics, and non-Hispanic whites are at the highest risk for the condition (Johnston & Dagar, 2020). Data from 2019 reveals that more than 172,000 people in Florida suffered fractures related to osteoporosis (Richens, 2021). Furthermore, approximately 19 percent of this population succumbed to their injuries (Richens, 2021). Additionally, the incidence of the condition is highest among white Hispanics living in Florida (Richens, 2021).

Epidemiological Analysis of the Problem

Descriptive epidemiology focuses on time, place, and the person. Based on time and place, data from the National Osteoporosis Foundation reveals that in 2018, at least 10 million people in the USA had been diagnosed with osteoporosis (Johnston & Dagar, 2020). Furthermore, approximately 43 million Americans had a low bone mass. The mortality rate among these patients was about 19 percent (Johnston & Dagar, 2020). On the other hand, in 2019, approximately 172,000 people in Florida suffered from fractures related to osteoporosis. Furthermore, mortalities were recorded in approximately 19 percent of this population (Richens, 2021).

Johnston and Dagar (2020) report that 18.8 percent of females in the USA have the condition compared to only 4.2 percent of males. Furthermore, the prevalence of osteoporotic fractures among people aged 50 years and above was about 12.6 percent (Johnston & Dagar, 2020). The incidence of low bone mineral density among this population was about 43 percent. Women accounted for about 51 percent of these cases whereas men accounted for about 33 percent of these cases (Johnston & Dagar, 2020). Additionally, the prevalence of osteoporosis was highest among individuals aged 65 and above (Johnston & Dagar, 2020).

Healthy People 2020 identifies people aged 50 and above as the high-risk population for osteoporosis. As such, Healthy People 2020 aimed to reduce the incidence of femoral osteoporotic fractures to less than or equal to 5.3 percent (CDC, 2021). Data reveals that this target has not been achieved. The prevalence of femur osteoporotic fractures is 6.3 percent (CDC, 2021).

Application of Healthy People 2020

Healthy People 2030 has six goals and objectives regarding osteoporosis. Firstly, it aims to minimize the percentage of adults (50 years and above) diagnosed with osteoporosis. The goal is to achieve a percentage of 5.5 (Health.gov, n.d.). The second goal is to increase the percentage of adults receiving screening for osteoporosis. The third goal is to increase the percentage of older adults who receive treatment for osteoporosis after suffering a fracture (Health.gov, n.d.). The fourth objective is to minimize the incidence of hip fractures recorded among older adults. Specifically, the goal is to achieve about 4.6 hip fracture-related hospitalizations for every 1000 older adults (Health.gov, n.d.). The fifth objective is to increase the intake of vitamin D among people aged 2 years and above. This aims at achieving a daily intake of about 19 micrograms. The sixth objective is to increase the intake of calcium among people aged 2 years and above (Health.gov, n.d.).

The screening of osteoporosis is accomplished by measuring bone mineral density. Various organizations have issued screening guidelines. Examples of these organizations are the National Osteoporosis Foundation (NOF) and the American Association of Clinical Endocrinologists (AACE) (Johnston & Dagar, 2020). According to the AACE’s criteria, screening should be done for women aged 60 and above, women with a body mass index of less than 20, and when fractures are recorded among post-menopausal women (Johnston & Dagar, 2020). NOF recommends screening women aged 65 and above, men aged 70 and above, and individuals at high risk for fracture (Hansen et al., 2021).

Population Level Planning Interventions

Various strategies are used for health promotion and prevention of osteoporosis. Firstly, the need for dietary modification is emphasized. This entails increasing the intake of foods rich in calcium and vitamin D (CDC, 2021). Vitamin D facilitates calcium absorption, whereas calcium is required for the development of bones (CDC, 2021). Secondly, physical exercise is recommended to improve muscle strength and build and maintain bone mineral density (CDC, 2021). Thirdly, lifestyle modifications such as quitting smoking and minimizing alcohol intake are recommended. Fourthly, pharmacological approaches are used in the management of osteoporosis. Examples of classes of medication used include bisphosphonates such as risedronate, parathyroid hormone analogs such as teriparatide, and selective estrogen receptor modulators such as raloxifene (Lin et al., 2022).

The outcomes being tracked include dietary modifications such as the intake of foods rich in calcium and vitamin D and regular screening to identify osteoporosis. These outcomes are tracked via annual surveys completed by the Centers for Disease Control, the National Center for Health Statistics and Prevention, and the U.S. Department of Health and Human Services (CDC, 2021; Health.gov, n.d.).

References

Centers for Disease Control and Prevention. (2021). Osteoporosis or Low Bone Mass in Older Adults: United States, 2017–2018. https://www.cdc.gov/nchs/products/databriefs/db405.htm#Key_findings

Hansen, D., Pelizzari, P., & Pyenson, B. (2021). Medicare cost of osteoporotic fractures. Milliman Research Report, August. https://www.milliman.com/en/insight/medicare-cost-of-osteoporotic-fractures#

Health.gov. (n.d.). Osteoporosis. https://health.gov/healthypeople/search?query=osteoporosis

Johnston, C. B., & Dagar, M. (2020). Osteoporosis in Older Adults. Medical Clinics of North America, 104(5), 873–884. https://doi.org/10.1016/j.mcna.2020.06.004

Lin, X. C., Guo, H. T., Lian, Y. G., Kou, J., Wang, G. L., Chen, Y. Y., Wang, J., Han, X., Jiang, M., & Yang, Q. H. (2022). Osteoporosis and Related Health Status Among the Elderly Urban Residents in Elderly-Care Inns in Beijing, a Multicenter DXA Survey. Frontiers in Endocrinology, 13(July), 1–13. https://doi.org/10.3389/fendo.2022.875678

Richens, M. (2021). American Bone Health, Healthy Bones Tampa Bay thank Florida Legislative Women’s Caucus for proclaiming May as Osteoporosis Awareness Month. https://americanbonehealth.org/osteoporosis/american-bone-health-healthy-bones-tampa-bay-thank-florida-legislative-womens-caucus-for-proclaiming-may-as-osteoporosis-awareness-month/#:~:text=As%20many%20as%20one%20in,172%2C500%20osteoporotic%20fractures%20in%202019.

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Week 2
HP2020 Paper: Topics & Objectives 2030

• Arthritis
• Osteoporosis
• Dementias

1. Research Topic: Your course faculty will provide you with topic/s for this assignment. Please check the NR503 Course Announcements.

2. Identify your target population (for instance, age or other demographic, aggregate population); this must be in your city or state.
3. Discuss population-based health education interventions for your target population that is aimed at reducing morbidity and mortality for the problem. Be sure to review the research literature and HP2020 for interventions.
4. Identify how and what data for interventions is being tracked.
5. In a four (4) page paper, address the following. Refer to the rubric for expanded details related to grading expectations.
o Identify the problem in the introduction section.
o Provide an overview of the problem in your state/nation.
o Review of descriptive epidemiological and demographic data on mortality/morbidity and risk.
o HP2020: Present the goal, overview, and objectives of Healthy People 2020 for the paper topic.
o Population-level prevention and health promotion review. Describe population and/or primary health care-focused interventions. Use of scholarly literature and HP2020 is required. There should be a direct correlation to evidence for all strategies.