Community centers 	↑/NC knowledge about hygiene and sanitation, ↑ water quality, ↓ diarrheal morbidity 	↑/NC knowledge about hygiene and sanitation, ↑ water quality, ↓ diarrheal morbidity 	↑/NC knowledge about hygiene and sanitation, ↑/NC hand-washing, ↑ water quality, NC waste disposal, ↓ diarrheal morbidity 	↑/NC knowledge about hygiene and sanitation, ↑ water quality, ↓ diarrheal morbidity 

Osteoporosis ranks sixth amongst chronic diseases of women in the United States, with an overall prevalence of 18%, and a much higher rate involving the femur, neck or lumbar spine amongst women (16%) than men (4%), over the age of 50 (Gronowski and Schindler, Table IV).[6][7][128] Osteoporosis is a risk factor for bone fracture and about 20% of senior citizens who sustain a hip fracture die within a year.[6] [129] The gender gap is largely the result of the reduction of estrogen levels in women following the menopause. Hormone Replacement Therapy (HRT) has been shown to reduce this risk by 25–30%,[130] and was a common reason for prescribing it during the 1980s and 1990s. However the Women's Health Initiative (WHI) study that demonstrated that the risks of HRT outweighed the benefits[131] has since led to a decline in HRT usage.
Consult your health care professional. Women of childbearing age may want to consider taking folic acid supplements to reduce the risk of having a pregnancy affected with neural tube defects. Many women and teenage girls don't get enough calcium or vitamin D, both of which are critical to healthy bones and avoiding osteoporosis. Some people with diabetes appear to benefit from chromium. Vegetarians, especially vegans, may want to consider supplements to obtain nutrients they aren't getting from animal products.
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