EXECUTIVE SUMMARY

Osteoporosis is an age-related disease that is characterized by decreased bone tissue and increased susceptibility to fractures. The National Osteoporosis Foundation (NOF) estimates that approximately 1.5 million fractures per year are osteoporosis related: 300,000 hip fractures, 700,000 vertebral fractures, 250,000 forearm fractures, and 250,000 fractures at other sites. One in every two women and one in eight men will suffer an osteoporotic fracture at some time in their lives. The current costs to the health care system are estimated to be nearly $14 billion annually, or $38 million each day.

Because osteoporosis primarily affects older people, it is of particular concern in West Virginia. In 1996 West Virginia had the oldest population in the nation, with a median age of 37.7, and ranked fourth in the U.S. in the proportion of its population that is elderly (65+).

Age, sex, race,lifestyle, and overall health are all factors in the development of osteoporosis, with older white women at highest risk. Other risk factors include a family history of the disease, menopause, amenorrhea, a small skeletal frame, low testosterone levels, endocrine disorders, certain medications, immobility, inadequate calcium intake and physical activity, cigarette smoking, excessive alcohol and caffeine consumption, and depression. Because peak bone mass is reached in early adulthood, the best defense against osteoporosis is educating young people on the dangers of bone loss in later life, with an emphasis on the importance of diet and exercise. For middle-aged and older individuals, hormonal and other drug therapies, weight-bearing exercise, and calcium supplementation are the major forms of prevention and limitation of further bone loss.

In the 1996 and 2015 Osteoporosis Prevalence Figures: State-by-State Report, the NOF estimates that in 1996 over one-half of all women aged 50 and older, or approximately six out of every ten in this age group, were at risk from or for osteoporosis in West Virginia. If no action is taken, a total of 227,246 women and 43,383 men in the state will have osteoporosis or low bone mass by 2015. The State Burden of Fractures, another predictive model, projects that among state women aged 45 and older:

• The incidence of all fractures will increase by 19% from 1995 through 2015.
• More than 41,000 will experience hip fractures during this period.
• Approximately 38,500 will suffer a wrist fracture between 1995 and 2015, and nearly 100,000 will experience vertebral fractures.
• Approximately 5,200 deaths from 1995 through 2015 will occur as a result of hip fractures.
  

Using data from the West Virginia Health Care Authority, it was estimated that in 1996 over two-thirds (3,944) of the 6,015 hospitalizations due to fractures among West Virginia residents aged 45 and older were osteoporosis related. Women accounted for approximately four out of every five (81%) osteoporotic fracture hospitalizations, with an average stay of 9.31 days for men and 8.83 days for women. Over $42 million was billed in 1996 for hospitalizations due to osteoporotic fractures, 65% of total charges for all fractures among persons aged 45 and older. The average charge per osteoporotic fracture among female patients was $10,219; the average charge among male patients was $13,166. The bulk of the osteoporosis-related charges, or approximately 86%, was billed to Medicare, reflecting the age of the majority of osteoporosis sufferers.

Given the aging of West Virginia's population, the public health burden of this disease will only become more devastating if action is not taken now.