Racial Disparities Exist in Outcomes After Major Fragility Fractures

BACKGROUND Fractures associated with postmenopausal osteoporosis (PMO) are associated with pain, disability, and increased mortality. A recent, nationwide evaluation of racial difference in outcomes after fracture has not been performed. OBJECTIVE To determine if 1‐year death, debility, and destitution rates differ by race. DESIGN Observational cohort study. SETTING US Medicare data from 2010 to 2016. PARTICIPANTS Non‐Hispanic black and white women with PMO who have sustained a fragility fracture of interest: hip, pelvis, femur, radius, ulna, humerus, and clinical vertebral. MEASUREMENTS Outcomes included 1‐year: (1) mortality, identified by date of death in Medicare vital status information, (2) debility, identified as new placement in long‐term nursing facilities, and (3) destitution, identified as becoming newly eligible for Medicaid. RESULTS Among black and white women with PMO (n = 4,523,112), we identified 399,000 (8.8%) women who sustained a major fragility fracture. Black women had a higher prevalence of femur (9.0% vs 3.9%; P