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Correspondence to Author: Slam Drif, 

Tawam Hospital, Oncology Department, Al-Ain, UAE.

The global coronavirus disease 2019 (COVID-19) pandemic has resulted in a disproportionate number of infections, hospitalizations, and fatalities among communities of color. (1) A backlash against racism in the United States has been sparked by events over the past 18 months, in addition to an increase in anti-Asian xenophobia and social justice demonstrations. Due to the regrettable history of racism in the medical sector, hospitals and other organizations are being forced to look for signs of bias in their own rules and procedures.The application of race and ethnicity to clinical decision-making is being examined in this context.(3) A wide range of factors, such as socioeconomic position, health practices, genetics, and access to medical treatment, affect health outcomes. The circumstances in which people live, learn, and work are known as social determinants of health, and although the relationships between these variables are complicated, it is evident that these factors have a significant role in health results.(4) There are numerous obstacles that surround the use of race and ethnicity into therapeutic algorithms. Although it’s a frequent misconception that racial inequalities in health outcomes are a reflection of hereditary or biological differences, race is a social construct, and systematic racism may have more of an impact. Furthermore, the Office of Management and Budget’s standardization of broad racial and ethnic categories aggragates varied subgroups and can conceal significant disparities within these populations. What part do race and ethnicity play in maintaining bone health? The Fracture Risk Assessment Tool (FRAX; https:// www.sheffield.ac.uk/FRAX/) is a widely used clinical calculator. gives the 10-year odds of a major osteoporotic fracture or a hip fracture based on clinical risk factors and optional foot mineral density (BMD) (BMD).5. FRAX offers 73 nation-specific models in addition to ethnicity-specific models in the US, Singapore, South Africa, and Africa. These models are created using algorithms derived from population-based cohorts in Europe, North America, Asia, and Australia.(6) Based on statistics showing that white, Hispanic, black, and Asian people had different fracture rates while having similar BMD, race/ethnicity-specific probabilities are provided for these groups in the United States.(7) Black, Hispanic, and Asian women receive reduced fracture risk estimates from the FRAX algorithm, raising concerns about the possibility of delaying osteoporosis treatment.(3) However, considering variations in the frequency of atypical femur fractures, an uncommon side effect of long-term Lower risk estimates for bisphosphonate use across racial and ethnic groups may effectively prevent overtreatment.(8) It should be noted that the identification of health disparities in the treatment of osteoporosis has been made possible by FRAX risk assessments.(6) It is evident that solid data are required to address these intricate problems, and Noel and colleagues’ review of racial and ethnic differences in bone health, published in this issue of JBMR, provides an upto-date assessment of the state of the field.

Citation:

Slam Drif. Taking Racial and Ethnic Differences into Account When Managing Bone Health. The Journal of Bone and Mineral Research 2024.