North America Policy Initiatives

United States of America

It’s estimated by 2020 half of all Americans over the age of 50 will have fragile bones. This is due to changes in population demographics, diet and lifestyle. The medical expense of caring for people with osteoporosis will run into the billions.

Osteoporosis advocacy in the USA is led by the National Osteoporosis Foundation (NOF), the nation’s leading health organization dedicated solely to osteoporosis and bone health. NOF delivers information and resources to help patients and health professionals; fosters understanding of osteoporosis risk factors and prevention and treatment options; drives quality and patient access to care; and works to advance medical research.

Policy reports

Surgeon General's Report on Bone Health and Osteoporosis

Released in October 2004, the ‘Surgeon General's Report on Bone Health and Osteoporosis’ is a comprehensive document that defines bone health and bone disease in accessible terms, reviews the status of the population's bone health and documents the magnitude of the problem facing the country.

In addition, the report tackles the issue of what can be done to improve bone health: from the perspective of the individual; from the perspective of the health care professional; and from the perspective of the health system.

Download an overview of The 2004 Surgeon General's Report on Bone Health and Osteoporosis: What It Means to You (PDF, 1.14 MB)

The full report can be found on the Surgeon General's website here.

National Action Plan for Bone Health: Recommendations from the Summit

This report provides an action plan and agenda to advance bone health promotion and disease prevention for the United States. It’s a direct result of the Summit for a National Action Plan for Bone Health, which in 2008 convened more than 150 stakeholders who share concern for America’s bone health.

The action plan is structured around four priority areas: developing a bone health alliance; promoting bone health and disease prevention; improving diagnosis and treatment; and enhancing research, surveillance and evaluation.

The report outlines recommended actions, responsibilities, and short-term and long-term timelines for priorities and programs for health professionals, health systems and population-based approaches to promote bone health.

Download the National Action Plan for Bone Health: Recommendations from the Summit


The risk of a major osteoporotic fracture in Canada is among the highest in the world (in the top quarter). Each year 30,000 Canadians break their hip. This is just the tip of the iceberg: many more Canadians suffer osteoporotic fractures affecting the spine, wrist, shoulder, and pelvis.

White papers

Key policy publications on the burden of osteoporosis in Canada have been issued by Osteoporosis Canada. These include:

Ontario Osteoporosis Strategy

Following publication of the Preventing a Fractured Future white paper, a far-reaching osteoporosis strategy was announced in the province of Ontario in 2005. This was supported by an ongoing financial investment by the provincial Government. As a result of the Osteoporosis Strategy, two projects specifically targeted to seniors are proposed: the first, a plan for educating seniors on osteoporosis through increasing their awareness of the modifiable risk factors, symptoms of osteoporosis and the various treatment options which are currently available.

The second project is the development of a prevention programme specifically designed for seniors. Although this is specifically an Ontario Ministry of Health and Long-term Care initiative, the strategy provides a model that could be adopted by other provinces in Canada. Read further information regarding the Ontario Initiative

National Guidelines

Read the list of osteoporosis guidelines for the North America region. Note, the International Osteoporosis Foundation does not endorse country guidelines. This is because osteoporosis prevalence and aspects of the prevention, diagnosis and treatment of osteoporotic fractures are country-specific. There may be multiple guidelines from any one country.

Facts and statistics

Read facts and statistics on osteoporosis and fractures in North America.