This nation faces a serious yet largely unknown health problem. More than one in 10 Americans either has or is at risk of developing a bone disease. Yet the vast majority of these individuals remain undiagnosed and untreated. As a result, bone disease exacts a huge toll on the nation. Osteoporosis, by far the most common bone disease, is responsible for approximately 1.5 million fractures each year. As many as 300,000 individuals who suffer an osteoporosis-related fracture die as a result of complications from the injury. Concerns about the large toll that bone diseases are inflicting on the nation has led the Surgeon General to launch a major campaign aimed at improving bone health. Bone health is critically important to the overall health and quality of life of Americans. Healthy bones provide the body with a frame that allows for mobility and for protection against injury. Bones serve as a storehouse for minerals that are vital to the functioning of many other life-sustaining systems in the body. Unhealthy bones, however, perform poorly in executing these functions and can lead to debilitating fractures. The bone health status of Americans appears to be in jeopardy, and left unchecked it is only going to get worse as the population ages. Each year an estimated 1.5 million individuals suffer an osteoporotic-related fracture. Great improvements in the bone health status of Americans can be made "simply" by applying in a timely manner that which is already known about prevention, assessment, detection, diagnosis, and treatment. There is a large gap between what has been learned and what is applied by American consumers and health care providers. The biggest problem is a lack of awareness of bone disease among both the public and health care professionals. An area of particular concern relates to serving ethnic and racial minorities and other underserved populations, including the uninsured, underinsured, and those living in rural areas. Closing this gap will not be possible without specific strategies and programs geared toward bringing improvements in bone health to all currently underserved populations. The area of bone health is ideally suited to a public health approach to health promotion.