Osteoporosis and low bone density are associated with a risk of fracture as a result of even minimally traumatic events. The estimated lifetime risk of osteoporotic fracture is as high as 50 percent, especially in white and Asian women. Osteoporosis is twice as common in white and Hispanic women as in black women. In white women 50 years and older, the lifetime risk of osteoporotic fractures approaches 40 percent. More than 90 percent of hip and vertebral fractures in elderly white women are attributed to osteoporosis. Osteoporosis is responsible for almost 1 million vertebral and hip fractures annually . In 1995, osteoporotic fractures resulted in 2.5 million physician visits, 432,000 hospitalizations, and 180,000 nursing home admissions. In the United States alone, annual medical expenditures for the management of osteoporotic fractures may be as high as $15 billion.