Building Bridges to Better Health

Latino Osteoporosis Health Collaborative

In Brief: This effort will increase awareness of osteoporosis and improve its management among Latinos in Contra Costa County who are at risk for the disease. After a year of planning , the collaborating partners (Foundation for Osteoporosis Research & Education (FORE), La Clínica de La Raza, Inc., The California Hispanic Osteoporosis Foundation, Procter & Gamble Pharmaceuticals, and Latino Consultants, LLC) are implementing a comprehensive intervention plan that includes social marketing, outreach, education, bone density screening, and disease management.

The Health Issue: Osteoporosis is a disease characterized by lower bone mass, which makes bones fragile and more likely to break. Hip fracture is a common result. For those over fifty who suffer a hip fracture, about 20-25% die within the next year and many more will never live independently again. Most tested messages and programs that have had some success among other populations have not resonated with Latinos. Therefore, limited awareness of the disease and other health disparity issues make this growing population particularly vulnerable. Research indicates that 33% of Latinas over 50 years of age have osteoporosis, and the incidence of hip fractures among Latinos has doubled over the last 25 years.

The Health Improvement Strategy: The partners have forged a multi-faceted intervention plan. To raise awareness, La Clínica and FORE train senior promotores (health educators) at La Clínica's Pittsburg and Monument clinics to deliver carefully researched messages at community events and individual visits. Simultaneously, Latino Consultants - media and health care consultants - are implementing a targeted social marketing campaign using a prominent medical spokesperson familiar to the Latino community: Univision's Aliza Lifshitz, MD. The social marketing campaign - including a new advertising slogan (¡Huesos fuertes ahora! - Strong Bones Now!) - seeks to reach older Latinos through Spanish language television and radio, a new web site, and bus stop billboards in Latino neighborhoods. All of these marketing efforts are designed to raise awareness and to attract Latinos to bone density screening events in their neighborhoods that FORE and La Clínica conduct.

In the first six months of implementation, 323 seniors were screened. The collaborators were alarmed to learn that nearly two-thirds of those screened (208) had low bone density - that's nearly twice the percentage of what prior research had found. Moreover, the age of those with low bone density in this group averaged about 10 years younger that it would be in the Caucasian community. This data confirms the importance of this health collaborative and convinced the partners there is a dramatic need to sustain their interagency efforts after support from the Community Health Fund ends.

Current health indicators also make Procter & Gamble's role more prominent, as many of the seniors identified with bone loss will need access to no or low-cost osteoporosis medications - and an important focus for the collaborative is to create access to health care for those who do not have a regular provider or coverage. La Clínica will take the lead in partnering with Procter & Gamble to allow easy access to osteoporosis drugs through La Clínica's pharmacy assistance program. Osteoporosis support groups are also important, and La Clínica's senior promotores will join forces with FORE's bilingual, bicultural community health educator to co-facilitate these groups.

Finally, the collaborative has hired an experienced professional evaluator - Colleen Denny-Garamendi, DrPH, MPH - to evaluate and document the collaborative process and the health improvements that result from it. The evaluation is examining everything from the number of people reached through awareness, attitudes, and beliefs regarding osteoporosis among older Latinos and compliance with recommended prevention and treatment strategies.

"I'd like to help fight osteoporosis because many people don't know they have it and I've seen the devastation it can cause. What is fantastic is that the most common causes for this disease can be prevented and the disease itself can be treated." Aliza Lifshitz, MD, Univision Medical Correspondent diagnosed with osteopenia (a precursor to osteoporosis).