OSTEOPOROSIS PREVALENCE IN WEST VIRGINIA

Risk Factors for Osteoporois Among West Virginians
National Osteoporosis Foundation Prevalence Estimats

State Burden of Fractures Model

Another method of estimating the extent of osteoporosis and osteopenia in West Virginia is through the use of the state burden of fractures model first presented by Merck and Company at the 1996 annual meeting of the American Society of Bone and Mineral Research (10). This model predicts the number of fractures that will be suffered by women aged 45 and older in each of the 50 states and the District of Columbia annually from 1995 through the year 2015. The model uses 1993 U.S. Census Bureau population data and estimates of fracture risk from (1) an epidemiological study conducted in Rochester, Minnesota, of white women, collected in five-year age groups, and (2) a 5% sampling of Medicare patients compiled between 1986 and 1990 and reported by race and five-year age intervals. A more detailed presentation of the state burden of fractures model methodology is found in Appendix C.

The following projections resulted from applying the model to West Virginia population data:

• The incidence of all fractures will increase by 19% during the twenty-year span.

• More than 41,000 women in the state will experience hip fractures during this period.

• Approximately 38,500 women will suffer a wrist fracture between 1995 and 2015, while nearly 100,000 women will experience vertebral fractures.

The graph below shows the projected number of hip, wrist, and vertebral fractures among women aged 45+ in West Virginia for the years 1995 through 2015.

In addition to predicting the number of hip, wrist, and vertebral fractures, the model also estimates hip fracture mortality (i.e., deaths occurring within one year of a hip fracture). The top line on the graph below, labeled "total deaths," represents the total number of women aged 50 and older expected to die within one year of a hip fracture. Since some of these women would have died of other causes during that year, not all the deaths can be attributed to the fracture. The line labeled "excess deaths" represents only those deaths that are directly related to the hip fracture. As depicted on the graph, the model predicts that from 1995-2015 approximately 8,400 West Virginia women aged 50 and older will die within a year following a hip fracture; of these, 5,200 deaths will be attributable to the fracture itself.