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Office of the Surgeon General (US). Report of the Surgeon General's Workshop on Osteoporosis and Bone Health: December 12 – 13, 2002, Washington, DC. Rockville (MD): Office of the Surgeon General (US); 2003.

Cover of Report of the Surgeon General's Workshop on Osteoporosis and Bone Health

Report of the Surgeon General's Workshop on Osteoporosis and Bone Health: December 12 – 13, 2002, Washington, DC.

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Wrap-up Summary

Dr. Moritsugu closed the meeting by acknowledging the tremendous efforts of the presenters and attendees, thanking them for offering their many different valuable perspectives on the area of bone health. He also reiterated Dr. Carmona’s commitment to bring hope to those suffering from bone disease and to invest in a strategy of prevention so that fewer Americans will suffer in the future. The Surgeon General’s Report will be the foundation upon which to build the awareness to move all the stakeholders–patients, health providers, policymakers, the research community, and the media—into action. If the energy, knowledge, and commitment of those at the workshop are any indication, the feasibility of concerted action is high.

Dr. Moritsugu highlighted four themes that he heard repeatedly over the two days:

First, the bone health status of the population must be assessed, problem areas identified, and a better understanding developed of why there are disparities between what can be done and what is being done.

Second, the challenge of competing priorities for meeting health care needs can be overcome by developing bone health strategies that are complementary to strategies for the prevention and treatment of other chronic diseases. A good diet, physical activity, and avoiding alcohol and tobacco will help prevent not only bone disease, but also diabetes, cardiovascular disease, cancer, and a host of other illnesses. This issue is a high priority for Dr. Carmona.

Third, bone health messages should be evidence-based and targeted to specific groups of people. Too many patients–including those who shared their personal perspectives at the workshop–simply do not know what they need to about bone health and bone disease. Physicians often lack the necessary knowledge as well. But by developing evidence-based messages and communicating them to those at risk, these patients’ children and grandchildren will not suffer the same unfortunate fates. Partnerships between professionals and an active, involved, informed populace are the key to success.

Finally, systems must be developed to enable health care providers to implement appropriate prevention, diagnosis, and treatment of bone diseases. Providers must be trained to use these systems.

As the nation embarks on addressing these challenges, Dr. Moritsugu urged all those involved not to forget the human aspects and the human stories, some of which were heard during the workshop. For example, Jean Mandeville offered a mother’s perspective on living with the illness of her son, Jay. While she described the terrible physical complications of Osteogenesis Imperfecta, she also highlighted his deep intelligence, his engaging personality, and the other joy he brings to life. Annie Lorigan described how her osteoporosis prevents her from hugging her grandchildren too tightly or going dancing. Linda Johnson reflected on the loss of independence she has faced because of osteoporosis, while Jewel Lewis chronicled how she lost a full foot in height from Paget’s Disease. Katherine Moy Chin shared the very real concerns that Asian women with bone disease face because of language and cultural barriers, while Thomas Carskadon offered a spirited–and at times light-hearted–plea for action to raise awareness among the public and medical community. And finally, the room was dead silent as 10-year-old Julie Gonzalez enthusiastically described learning about bone health with her Girl Scout troop. As Susan Dentzer noted in her remarks, these types of human stories and faces are critical to getting the message out to the public, and they are multiplied by 10 million in this country alone.

Dr. Moritsugu reiterated Dr. Carmona’s desire not to write another Federal report that sits on a shelf. As Dr. Slater noted in her remarks, Surgeon General’s Reports throughout the years have been catalysts for action to improve the health of Americans. Dr. Carmona is passionate about the need for action, not just talk, and is committed to seeing that the report on bone health has an equal–if not greater–impact on the lives of individuals. For those who care about bone disease, therefore, the development of this report is the beginning of a tremendous opportunity to bring about an improvement in health, an opportunity that must be seized by everyone, since everyone has an important role to play. The key is to get the message out to providers, to those who suffer bone disease, and to the public at large about the scope of the problem, about the science of prevention, diagnosis, and treatment of bone disease, and (most importantly perhaps) about behavior change. While the media can help with the message, each stakeholder must also carry it within its sphere of influence. In closing, Dr. Moritsugu reminded the audience of Judith Cranford’s warning that while “bone disease is often silent, we cannot be silent.” He also made a final plea for concerted action by echoing the words of a former Surgeon General who cautioned that the “difference between what we know and what we do can be deadly.”

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