SEC. 2. FINDINGS.
The Congress finds that—
(1) osteoporosis, or porous bone, is a condition
characterized by an excessive loss of bone tissue and
an increased susceptibility to fractures of the hip,
spine, and wrist;
(2) osteoporosis is a threat to an estimated
25,000,000 Americans, 80 percent of whom are
women, many of whose cases go undiagnosed be-
cause the condition develops without symptoms until
a strain, bump, or fall causes a fracture;
(3) between 3 and 4 million Americans have
Paget’s 
disease, 
osteogenesis 
imperfecta,
hyperparathyroidism, and other related metabolic
bone diseases;
(4) osteoporosis is responsible for 1,500,000
bone fractures annually, including more than
250,000 hip fractures, 500,000 vertebral fractures,
200,000 fractures of the wrist, and the remaining
fractures at other limb sites;
(5) 1 of every 2 women and 1 of every 8 men
over age 50 will develop fractures associated with
osteoporosis;
(6) direct medical costs of osteoporosis are esti-
mated to be $10,000,000,000 annually for the Unit-
ed States, not including the costs of family care and
lost work for caregivers;
(7) direct medical costs of osteoporosis are ex-
pected to increase precipitously because the propor-
tion of the population comprised of older persons is
expanding and each generation of older persons
tends to have a higher incidence of osteoporosis than
preceding generations;
(8) technology now exists, and new technology
is developing, that will permit early diagnosis and
prevention of osteoporosis as well as management of
the condition once it has developed;
(9) funding for research on osteoporosis and re-
lated bone diseases is severely constrained at key re-
search institutes, including the National Institute of
Arthritis and Musculoskeletal and Skin Diseases, the
National Institute on Aging, the National Institute
of Diabetes and Digestive and Kidney Diseases, the
National Institute of Dental Research, and the Na-
tional Institute of Child Health and Human Devel-
opment;
(10) further research is needed to improve med-
ical knowledge concerning—
(A) cellular mechanisms related to the
processes of bone resorption and bone forma-
tion, and the effect of different agents on bone
remodeling;
(B) risk factors for osteoporosis, including
newly discovered risk factors, risk factors relat-
ed to groups not ordinarily studied (such as
men and minorities), risk factors related to
genes that help to control skeletal metabolism,
and risk factors relating to the relationship of
aging 
processes 
to 
the 
development 
of
osteoporosis;
(C) bone mass measurement technology,
including more widespread and cost-effective
techniques for making more precise measure-
ments and for interpreting measurements;
(D) calcium (including bioavailability, in-
take requirements, and the role of calcium in
building heavier and denser skeletons), and vi-
tamin D and its role as an essential vitamin in
adults;
(E) prevention and treatment, including
the efficacy of current therapies, alternative
drug therapies for prevention and treatment,
and the role of exercise; and
(F) rehabilitation; and
(11) further educational efforts are needed to
increase public and professional knowledge of the
causes of, methods for avoiding, and treatment of
osteoporosis.
SEC. 3. OSTEOPOROSIS RESEARCH.
Subpart 4 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285d et seq.) is amended by adding
at the end the following new section:
‘‘SEC. 442A. RESEARCH ON OSTEOPOROSIS AND RELATED
DISEASES.
‘‘(a) EXPANSION OF RESEARCH.—The Director of
the Institute, the Director of the National Institute on
Aging, the Director of the National Institute of Diabetes
and Digestive and Kidney Diseases, the Director of the
National Institute of Dental Research, and the Director
of the National Institute of Child Health and Human De-
velopment shall expand and intensify research on
osteoporosis and related bone diseases. The research shall
be in addition to research that is authorized under any
other provision of law.
‘‘(b) MECHANISMS FOR EXPANSION OF RESEARCH.—
Each of the Directors specified in subsection (a) shall, in
carrying out such subsection, provide for one or more of
the following:
‘‘(1) Investigator-initiated research.
‘‘(2) Funding for investigators beginning their
research careers.
‘‘(3) Mentorship research grants.
‘‘(4) Specialized centers.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There
are authorized to be appropriated to carry out this section
$30,000,000 for the National Institute of Arthritis and
Musculoskeletal and Skin Diseases, $6,500,000 for the
National Institute on Aging, $6,500,000 for the National
Institute of Diabetes and Digestive and Kidney Diseases,
$4,000,000 for the National Institute of Dental Research,
and $3,000,000 for the National Institute of Child Health
and Human Development for each of the fiscal years 1997
through 1999, and such sums as may be necessary for
subsequent fiscal years. These funds are in addition to
amounts authorized to be appropriated for biomedical re-
search relating to osteoporosis and related bone diseases
under any other provision of law.
‘‘(d) RELATED BONE DISEASES DEFINED.—As used
in this section, the term ‘related bone diseases’ includes—
‘‘(1) Paget’s disease, a bone disease character-
ized by enlargement and loss of density with bowing
and deformity of the bones;
‘‘(2) osteogenesis imperfecta, a familial disease
marked by extreme brittleness of the long bones;
‘‘(3) hyperparathyroidism, a condition charac-
terized by the presence of excess parathormone in
the body resulting in disturbance of calcium metabo-
lism with loss of calcium from bone and renal dam-
age;
‘‘(4) hypoparathyroidism, a condition character-
ized by the absence of parathormone resulting in
disturbances of calcium metabolism;
‘‘(5) renal bone disease, a disease characterized
by metabolic disturbances from dialysis, renal trans-
plants, or other renal disturbances;
‘‘(6) primary or postmenopausal osteoporosis
and secondary osteoporosis, such as that induced by
corticosteroids; and
‘‘(7) other general diseases of bone and mineral
metabolism including abnormalities of vitamin D.’’.
Æ