A friend of mine with Central American, Southern European and West African ancestry is lactose intolerant. Drinking milk products upsets her stomach, and so she avoids them. About a decade ago, because of her low dairy intake, she feared that she might not be getting enough calcium, so she asked her doctor for a bone density test. He responded that she didn’t need one because “blacks do not get osteoporosis.”
My friend is not alone. The view that black people don’t need a bone density test is a longstanding and common myth. A 2006 study in North Carolina found that out of 531 African American and Euro-American women screened for bone mineral density, only 15 percent were African American women — despite the fact that African American women made up almost half of that clinical population. A health fair in Albany, New York, in 2000, turned into a ruckus when black women were refused free osteoporosis screening. The situation hasn’t changed much in more recent years.
Meanwhile, FRAX, a widely used calculator that estimates one’s risk of osteoporotic fractures, is based on bone density combined with age, sex and, yes, “race.” Race, even though it is never defined or demarcated, is baked into the fracture risk algorithms.
Let’s break down the problem.
First, presumably based on appearances, doctors placed my friend and others into a socially defined race box called “black,” which is a tenuous way to classify anyone.