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Aging Bones

A Short History of Osteoporosis

Gerald N. Grob

Publication Year: 2014

In the middle of the twentieth century, few physicians could have predicted that the modern diagnostic category of osteoporosis would emerge to include millions of Americans, predominantly older women. Before World War II, popular attitudes held that the declining physical and mental health of older persons was neither preventable nor reversible and that older people had little to contribute. Moreover, the physiological processes that influenced the health of bones remained mysterious. In Aging Bones, Gerald N. Grob makes a historical inquiry into how this one aspect of aging came to be considered a disease. During the 1950s and 1960s, as more and more people lived to the age of 65, older people emerged as a self-conscious group with distinct interests, and they rejected the pejorative concept of senescence. But they had pressing health needs, and preventing age-related decline became a focus for researchers and clinicians alike. In analyzing how the normal aging of bones was transformed into a medical diagnosis requiring treatment, historian of medicine Grob explores developments in medical science as well as the social, intellectual, economic, demographic, and political changes that transformed American society in the post–World War II decades. Though seemingly straightforward, osteoporosis and its treatment are shaped by illusions about the conquest of disease and aging. These illusions, in turn, are instrumental in shaping our health care system. While bone density tests and osteoporosis treatments are now routinely prescribed, aggressive pharmaceutical intervention has produced results that are inconclusive at best. The fascinating history in Aging Bones will appeal to students and scholars in the history of medicine, health policy, gerontology, endocrinology, and orthopedics, as well as anyone who has been diagnosed with osteoporosis.

Published by: The Johns Hopkins University Press

Title Page, Copyright Page

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pp. i-iv

Contents

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pp. v-vi

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Foreword

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pp. vii-xii

Disease is a fundamental aspect of the human condition. Ancient bones tell us that pathological processes are older than humankind’s written records, and sickness and death still confound us. We have not banished pain, disability, or the fear of death, even...

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Preface

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pp. xii-xviii

For most of my career I have been preoccupied with writing about the history of mental health policy and psychiatry in the United States. Given my interest in the history of medicine, in the 1970s a dean at my university suggested that perhaps I could...

List of Abbreviations

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pp. xix-xx

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Chapter One. History and Demography

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pp. 1-23

In mid-twentieth-century America, few physicians would have predicted that within decades the modern diagnostic category of osteoporosis would emerge and include millions of Americans, predominantly older women. Prior to World War II, popular attitudes...

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Chapter Two. The Origins of a Diagnosis

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pp. 24-53

The diagnostic category of osteoporosis did not appear until the mid-twentieth century, because of the weakness in and complexity of the knowledge base about bone physiology. Progress in illuminating the manner in which bones developed and changed...

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Chapter Three. The Transformation of Osteoporosis

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pp. 54-85

Concerns with the diagnostic category of osteoporosis grew, and even accelerated, as the decades passed, which was reflected in the number of published articles on this topic. Articles listed under the heading “osteoporosis (limited to English)” in PubMed in...

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Chapter Four. Popularizing a Diagnosis

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pp. 86-119

By the mid-1980s, concern with osteoporosis was no longer confined to a small clinical and research community. Interest in the diagnosis had expanded dramatically in America and included not only a broad public composed of ever larger numbers of women...

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Chapter Five. Internationalizing Osteoporosis

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pp. 120-146

“Despite the current prominence of AIDS,” wrote Robert P. Heaney in 1991, “osteoporosis may well be the disease of the 1990s.” Osteoporosis, along with Alzheimer’s disease, had the potential to become a budget buster. Even if disease prevalence among the...

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Chapter Six. Therapeutic Expansion

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pp. 147-176

Although concern with osteoporosis accelerated during and after the 1980s, the therapeutic armamentarium remained relatively limited. ERT was by far the most frequently prescribed medication, even though there were disagreements on how it should...

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Chapter Seven. Osteoporosis Triumphant?

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pp. 177-230

In July 1990, President George H. W. Bush signed a proclamation designating 1990–2000 the Decade of the Brain. The goal was “to enhance public awareness of the benefits to be derived from brain research.” The designation resulted in an extraordinary increase...

Notes

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pp. 231-274

Index

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pp. 275-284


E-ISBN-13: 9781421413198
E-ISBN-10: 1421413191
Print-ISBN-13: 9781421413181
Print-ISBN-10: 1421413183

Page Count: 304
Publication Year: 2014

Series Title: Johns Hopkins Biographies of Disease
Series Editor Byline: Charles E. Rosenberg, Series Editor