November 15, 2004

Health Center Physician Hopes to Boost
Awareness of Bone Health
by Kristina Goodnough

When the nation’s surgeon general released his first ever report on bone health at a press conference in Washington, D.C., last month, the Health Center’s Dr. Lawrence Raisz was at his side as one of the scientific editors.

Raisz, a Board of Trustees Distinguished Professor, has spent a lifetime of research on bone metabolism. “We have made huge strides in the science of bone health in the last several decades, but awareness about the issue has stayed fairly narrow,” says Raisz, whose own research began more than 40 years ago with an interest in calcium metabolism. “It’s not something that catches the eye.

“The whole point of the surgeon general’s report is to build awareness about a broad public health problem,” he adds.

Dr. Lawrence Raisz is one of the scientific editors of the surgeon general’s recent report on bone health.

Photo by Peter Morenus

The problem is widespread. In his report, Surgeon General Dr. Richard H. Carmona, warns that by the year 2020, half of all American citizens older than 50 will be at risk for fractures from osteoporosis and low bone mass if immediate action is not taken by individuals at risk, doctors, health systems, and policymakers.

“We know now that you are never too old or too young to improve your bone health,” says Raisz, who is acting director of the Health Center’s new Musculoskeletal Institute, which focuses on research and treatment aimed at orthopedics, arthritis, bone biology, biomechanics, and biomaterials. “For years, it was pretty standard thinking that poor bone health was a normal part of aging. Now we know that it isn’t, and we know there are effective ways to improve your bone health throughout your life.”

Osteoporosis and other bone diseases, such as Paget’s disease and osteogenesis imperfecta, can lead to a downward spiral in physical health and quality of life, according to the surgeon general’s report.

“Bone disease is a silent disease, until you fracture,” Raisz adds. “About 20 percent of senior citizens who suffer a hip fracture die within a year of the fracture. About 20 percent of individuals with a hip fracture end up in a nursing home within a year, and the direct care costs of osteoporotic fractures alone are about $18 billion annually.”

Preventive measures are fairly straightforward, and include exercise, increasing calcium and vitamin D in the diet, and not smoking. “I used to say these were simple steps, but the experience shows that for many people these are not simple things to do on a daily basis,” he says.

Raisz adds that although there have been great advances in treating osteoporosis in recent years, the disease can’t be treated if people are unaware of it. According to the surgeon general’s report, four times as many men and nearly three times as many women have osteoporosis as report having the condition.

“In the report, we stress the need for much greater awareness among all health care professionals of the early indicators of bone disease,” says Raisz.

“Physicians should be especially alert to a fracture from a moderate trauma that occurs in their patients older than 45,” he adds. “For example, if a patient age 45 or older suffers a fracture from a fall from a standing height or less, the physician should think about the possibility of poor bone health and recommend testing for osteoporosis and other bone diseases.”

The surgeon general’s report on bone health is available at http://www.hhs.gov/surgeongeneral/library/bonehealth/