• Diane S Lauderdale, Victoria Kuohung, Suey-Lee Chang, and Marshall H Chin.
• Department of Health Studies, University of Chicago, 5841 S. Maryland Ave., MC2007, Chicago, IL 60637, USA. lauderdale@uchicago.edu
• J Gen Intern Med. 2003 Jul 1; 18 (7): 508515508-15.

BackgroundData about whether Asian Americans are a high-risk or a low-risk group for osteoporosis are limited and inconsistent. Few previous studies have recognized that the heterogeneity of the Asian American population, with respect to both nativity (foreign- vs U.S.-born) and ethnicity, may be related to osteoporosis risk.ObjectiveTo assess whether older foreign-born Chinese Americans living in an urban ethnic enclave are at high risk of osteoporosis and to refer participants at high risk for follow-up care.DesignCross-sectional survey and osteoporosis screening, undertaken as a collaborative project by the Chinese American Service League and researchers at the University of Chicago.SettingChicago's Chinatown.ParticipantsFour hundred sixty-nine immigrant Chinese American men and women aged 50 and older.Measurements And Main ResultsChinese Americans in this urban setting are generally recent immigrants from south China with limited education and resources: mean age at immigration was 54, 56% had primary only or no education, and 57% reported "fair" or "poor" self-rated health. Eighteen percent are uninsured and 55% receive Medicaid. Bone mineral density (BMD) of the calcaneus was estimated using quantitative ultrasound. Immigrant Chinese women in the study had lower average BMD than reference data for white women or U.S.-born Asian Americans. BMD for immigrant Chinese men in the study was similar to white men at ages 50 to 69, and lower at older ages. Low body mass index, low educational attainment and older age at immigration were all associated with lower BMD.ConclusionsForeign-born Chinese Americans may be a high-risk group for osteoporosis.

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