Bridging Bone Health: Osteoporosis Disparities in the Rio Grande Valley

INTRODUCTION

Osteoporosis is characterized by decreased bone mass and decreased bone quality, leading to increased bone fragility and risk of fractures. The number of fractures due to osteoporosis is projected to increase to over three million by the year 2025 and cost $25.3 billion annually. It ranks highly among diseases that cause patients to become bedridden with serious complications and reduced quality of life. Additionally, osteoporosis disproportionately affects Hispanics, which comprise most of the Rio Grande Valley (RGV) population. Therefore, our primary objective was to determine the prevalence of osteoporosis within the RGV. Additionally, we had secondary objectives to determine the screening rates of osteoporosis in the RGV and identify other potential risk factors associated with osteoporosis. We hypothesize that individuals residing in the RGV have higher rates of osteoporosis and lower rates of osteoporosis screening than the national average.

METHODS

This retrospective observational cross-sectional study utilized Medicare beneficiary data via the "Mapping Medicare Disparities by Population" interactive tool. Osteoporosis data were compared within the RGV (comprising Starr, Hidalgo, Cameron, and Willacy counties) and compared with national averages between the years 2016 and 2021. Statistical analysis included prevalence ratios with 95% confidence intervals and chi-square values when applicable.

RESULTS

Among Medicare beneficiaries residing in the RGV, there are higher rates of osteoporosis compared to the national average (11.5% vs. 7.20%; p < .00001). Screening for osteoporosis within the RGV is above the national average (9.29% vs. 6.67%, p < .00001). Hispanics residing in the RGV have higher overall rates of osteoporosis than Caucasians residing in the RGV (12.3% vs. 8.60%, p < .00001). Females residing in the RGV have nearly twice the rate of osteoporosis compared to the national average (19.1% vs. 11.8%, p < .00001) and 6.58 times the rate of males residing in the RGV (19.1% vs. 2.9%, p < .00001).

CONCLUSION

Individuals residing in the RGV are disproportionately affected by osteoporosis. Despite increased screening rates seen among Medicare beneficiaries, we also suspect many individuals, uninsured or undocumented, have not received any appropriate osteoporosis screening. Risk factors in the RGV associated with higher rates of osteoporosis could include low education levels, socioeconomic status, physical activity, and mineral intake. These results demonstrate a need to address osteoporosis health literacy, promote earlier interventions to treat osteoporosis and increase healthcare accessibility in the RGV.

Innovative approaches to promote a culturally competent, diverse health care workforce in an institution serving Hispanic students

The underrepresentation of minorities among health care providers and researchers is often considered one of the contributing factors to health disparities in these populations. Recent demographic shifts and the higher proportion of minorities anticipated among the newly insured under the Patient Protection and Affordable Care Act make the need for a more diverse and culturally competent health care workforce an urgent national priority.The authors describe current and future strategies that have been developed at the College of Health Sciences and Human Services at the University of Texas-Pan American (an institution with 89% Hispanic students in 2012) to prepare a culturally competent and ethnically diverse health care workforce that can meet the needs of a diverse population, especially in the college's own community. The college graduates approximately 650 students annually for careers in nursing, physician assistant studies, occupational therapy, pharmacy, rehabilitation services, clinical laboratory sciences, dietetics, and social work. The college's approach centers on enriching student education with research, service, and community-based experiences within a social-determinants-of-health framework. The approach is promoted through an interdisciplinary health disparities research center, multiple venues for community-based service learning, and an innovative approach to improve cultural and linguistic competence. Although the different components of the college's approach are at different developmental stages and will benefit from more formal evaluations, the college's overall vision has several strengths that promise to serve as a model for future academic health initiatives.

Alternative health practices in ethnically diverse rural areas: a collaborative research project

Many alternative health practices are gaining popularity in traditional medical centers throughout the country. However, social workers and allied health professionals are rarely educated in these practices. The collaborative pilot research project discussed in this article involved community health providers and a state university department of social work. The project, conducted in rural health clinics, introduced an approach to skillful, safe, and appropriate use of touch synthesized with an awareness of the breath for giver and receiver to a group of Mexican Americans diagnosed with diabetes and their families. This alternative health practice holds promise for reducing stress, promoting health and well-being, and building relationships and warrants further study.