Social Determinants of Preventive Testing and Adherence to Treatment for Osteoporosis

The identification of osteoporosis prior to fracture and effective postfracture care is imperative to public health. However, disparities exist in screening, diagnosis and treatment of osteoporosis between sexes, social groups and ethnicities. Indeed, the osteoporosis ‘care gap’, itself a worldwide phenomenon, is disproportionately experienced by socially disadvantaged groups. Here we discuss barriers to prevention and treatment adherence in socially disadvantaged populations and potential strategies to increase uptake of testing and treatment, including non-pharmacological and pharmacological management. Postfracture care pathways are explored, as is the role played by low health literacy in the prevention and treatment of osteoporosis. At the broader scale, strategies to promote the development and implementation of health policies are key to reducing social and ethnic disparities in osteoporosis-related care and to improving health communications and healthcare systems that are accessible and equitable: this requires a whole-of-government and whole-of-society approach.