Bone Health pp 55-69 | Cite as

Bone Quality in Socially and Ethnically Diverse Groups: Downstream and Upstream Determinants Across the Life Course

  • Sharon L. Brennan-OlsenEmail author
  • Natalie K. Hyde
  • Rachel L. Duckham
  • Ayse Zengin
  • Jason Talevski
  • Darci Green
  • Sarah M. Hosking


Environmental factors begin to influence bone health in utero and continue across the life course, ultimately influencing our lifelong prospects of good bone health. These social-environmental forces are referred to as the Social Determinants of Health (SDoH) and result in the social patterning of health outcomes: a phenomenon referred to as the social gradient of health and disease. In this chapter, we begin with an overview of the SDoH and collate evidence regarding the social gradient of bone health. In addition to the influence of individual-level disadvantages on bone health, influences at the community/neighbourhood and political and environmental levels are discussed. We discuss the potential to reduce the risk of poor bone health in socially disadvantaged persons by focussing clinical attention towards identifying those most at risk, improving health literacy and affording extra time to ensure effective health communications.


Bone Ethnicity Health literacy Osteoporosis Social disadvantage 


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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Sharon L. Brennan-Olsen
    • 1
    • 2
    Email author
  • Natalie K. Hyde
    • 3
  • Rachel L. Duckham
    • 2
    • 4
  • Ayse Zengin
    • 5
  • Jason Talevski
    • 2
    • 1
  • Darci Green
    • 2
    • 1
  • Sarah M. Hosking
    • 3
  1. 1.Department of Medicine-Western HealthUniversity of MelbourneMelbourneAustralia
  2. 2.Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western HealthSt AlbansAustralia
  3. 3.Faculty of HealthDeakin UniversityGeelongAustralia
  4. 4.Deakin University, Institute for Physical Activity and Nutrition SciencesGeelongAustralia
  5. 5.Department of MedicineSchool of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Monash Medical CentreClaytonAustralia

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