Abstract
Osteoporotic fractures are a major public health problem and skeletal health varies widely across ethnic, racial, and geographic groups. In the USA, population growth among minority groups has been more rapid compared to whites over the last decade. Therefore, understanding factors contributing to skeletal health in non-white racial/ethnic populations is imperative. Studies of areal bone mineral density (aBMD) generally indicate the highest aBMD in African Americans followed by Hispanics, whites, and Native Americans, with the lowest aBMD in Asian Americans. However, racial differences in fracture risk do not necessarily parallel racial differences in aBMD. In general, the lowest fracture risk is observed among African Americans, followed by Asian Americans and Hispanics, with the highest fracture risk in non-Hispanic whites and Native Americans. The paradoxical low fracture risk in Asian Americans despite low aBMD may be due to differences in bone microarchitecture, bone geometry, or non-skeletal factors.
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