Osteoporosis affects about 12.6% of U.S. adults aged 50 and older, roughly one in eight people in that age group. But the fuller picture is more striking: an additional 43% have low bone mass (called osteopenia), which means their bones are weaker than normal but haven’t yet crossed the threshold into osteoporosis. Together, more than half of Americans over 50 have some degree of bone loss.
U.S. Prevalence by Gender
Osteoporosis is far more common in women than men. Among Americans 50 and older, 19.6% of women have osteoporosis compared to 4.4% of men, based on bone density measurements at the hip and spine. For low bone mass, the gap narrows but remains significant: 51.5% of women versus 33.5% of men.
These numbers undercount the real burden in men. Screening is much less common in men, and there’s ongoing debate about which bone density cutoffs best apply to male skeletons. One estimate using Medicare data found that about 25% of the male Medicare population had osteoporosis. In the European Union, prevalence in men jumps from 6.6% at age 50 to 16.6% by age 80. About one in four men over 50 will break a bone due to osteoporosis at some point in their life.
How Prevalence Differs by Race and Ethnicity
Bone density and fracture risk vary meaningfully across racial and ethnic groups. In the U.S., Asian women and men have the highest rates of osteoporosis. Among Asian women, 40% meet the diagnostic threshold for osteoporosis, and 47% have low bone mass. Among Asian men, 7.5% have osteoporosis and nearly 48% have low bone mass.
Black adults have the lowest rates. Only 8.2% of Black women and 1.9% of Black men have osteoporosis, and they also lose bone more slowly with age. Hispanic adults fall somewhere in between, with osteoporosis rates similar to or slightly higher than white adults depending on the study. White adults carry the highest overall burden of fragility fractures. Hip fracture rates per 100,000 people illustrate the spread clearly: 288 for white adults, 198 for Hispanic adults, 148 for Asian adults, and 87 for Black adults.
Global Numbers
A large meta-analysis covering more than 103 million people estimated global osteoporosis prevalence at 18.3%. That translates to roughly 8.9 million fractures worldwide every year, or one osteoporotic fracture every three seconds. Prevalence varies by continent. Africa had the highest estimated rate at 39.5%, though this was based on a small sample and may reflect limited screening infrastructure capturing only severe cases. Europe and Asia both showed higher prevalence than the U.S. or Australia.
The problem is growing. Projections estimate that between 2030 and 2034, the world will see about 263 million new osteoporosis cases, split roughly 154 million in women and 109 million in men. Aging populations in nearly every region are driving those numbers upward.
How Osteoporosis Is Measured
Osteoporosis is diagnosed through a bone density scan, which produces a number called a T-score. This score compares your bone density to that of a healthy 30-year-old. A T-score of negative 1 or higher is considered healthy. Between negative 1 and negative 2.5 is classified as osteopenia, meaning your bones are thinner than normal but not yet in the osteoporosis range. A T-score of negative 2.5 or lower indicates osteoporosis.
The scan itself is quick and painless, typically measuring bone density at the hip and lower spine. For most women, screening is recommended starting at age 65. For men, guidelines generally suggest starting at 70, though earlier screening makes sense if you have risk factors like long-term steroid use, low body weight, smoking, or a family history of fractures.
A Widely Underdiagnosed Condition
One of the most concerning aspects of osteoporosis is how often it goes undetected, even after a fracture makes the diagnosis obvious. Among postmenopausal women who had already broken a bone, only about 42% had been formally diagnosed with osteoporosis. In the U.S., only about 30% of patients who suffered a low-energy fracture (the kind caused by weakened bone, not a car accident) received any osteoporosis treatment afterward.
The treatment gap is enormous. In one national analysis, an estimated 2.25 million women had experienced a fragility fracture, yet fewer than 200,000 were receiving standard bone-strengthening medication. That means less than 10% of women who clearly needed treatment were actually getting it. This gap exists partly because osteoporosis causes no symptoms until a fracture happens. There’s no pain, no warning sign. The first indication is often a broken wrist from a minor fall or a vertebral compression fracture that shows up as sudden back pain or gradual height loss.
Why Fractures Matter So Much
Osteoporosis wouldn’t command this much attention if it were just about bone density numbers on a scan. The reason it matters is fractures, and their consequences can be severe. Hip fractures are the most dangerous. In a study of older adults (average age 86), 11% died within 30 days of a hip fracture. At one year, the death rate reached 34%. By four years, two-thirds had died.
These numbers are worst in the elderly, but fractures at any age carry real costs. People with osteoporosis spend an average of $8,572 more per year on healthcare than people without it, driven largely by hospitalizations and medications. Beyond dollars, fractures frequently lead to chronic pain, loss of independence, fear of falling, and reduced mobility that can spiral into further health decline.
Who Is Most at Risk
Several factors increase the likelihood of developing osteoporosis beyond the big three of age, female sex, and menopause. Low body weight is one of the strongest predictors. A family history of hip fracture roughly doubles your own risk. Smoking accelerates bone loss, and heavy alcohol use does the same. Certain medications, particularly corticosteroids taken for months or years, directly weaken bone. Conditions that reduce nutrient absorption, like celiac disease or inflammatory bowel disease, also raise risk because they limit calcium and vitamin D uptake.
Physical inactivity plays a role that’s easy to underestimate. Bone responds to mechanical stress by building itself up. Weight-bearing exercise (walking, running, resistance training) signals your body to maintain or increase bone density. A sedentary lifestyle removes that signal, letting bone thin faster than it otherwise would. This is one reason astronauts lose bone rapidly in space and why prolonged bed rest causes measurable bone loss within weeks.