Racial differences in fracture risk.

Blacks appear to have a lower risk of fractures than whites, but there has been little research regarding racial differences in the risk of fractures at sites other than the hip. We used Medicare claims to investigate the risks of fractures of the hip, distal forearm, proximal humerus, and ankle among American whites and blacks over 65 years old. Each of these fractures occurred more frequently in women than in men and (except for ankle fracture) displayed an increase in risk with age. Blacks had a lower risk than whites, although these differences were smaller for fractures of the ankle and were less pronounced among men. The most likely explanation for this is a constitutional or metabolic factor prevalent in blacks that particularly influences the risk of osteoporotic fractures in women.