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Ethnic diversity and lower socioeconomic populations are poorly captured in most studies of osteoporosis and fracture risk. This article describes a prospective, observational study designed to analyze risk factors for fracture in an ambulatory, ethnically diverse, urban population aged ge;55 yr. The goal of the study was to determine the number of fractures associated with hypovitaminosis D (≤15 ng/mL serum 25-hydroxyvitamin D) and osteopenia (T-score <−1.5) by bone mineral density (BMD). From January 1 to July 31, 2001, we identified 262 persons who fractured in our community; 83 chose to enroll in the study. Enrolled patients had a BMD examination at two sites; their blood was drawn for 25-hydroxyvitamin D (25VitD), calcium, phosphorus, albumin, and alkaline phosphatase. At the completion of the study a letter was sent to the patients detailing the findings, and a copy sent to their physician. Of the 83 persons enrolled, 73 (88%) had evidence of osteopenia or osteoporosis (T-score <−1.5) and/or low 25VitD. All fractures in the community in person ge;55 yr, with or without a history of antecedent trauma, should be assessed with BMD and screening for 25VitD.