With the deepening aging of China's population and the growing prominence of health issues among adolescents, bone health has emerged as a critical factor affecting the nation's overall health and quality of life. The report of the 20th National Congress of the Communist Party of China emphasized the implementation of a national strategy to actively respond to population aging, while the Healthy China 2030 Planning Outline advocates for the launch of a "Healthy Bones Initiative".

Focusing on the key populations of "the elderly and the young" in China's primary-level regions, this study analyzes the epidemiological status and influencing factors of representative bone health conditions-osteoporosis, adolescent idiopathic scoliosis, and lumbar disc herniation-in order to provide scientific evidence for the formulation of national and local health policies.

Relying on the strategic research and consultation project of the Chinese Academy of Engineering, a comprehensive literature search was conducted across databases including CNKI, PubMed, WHO, Embase, and Cochrane Library. The focus was on recently published sources such as the National Health Statistical Yearbook, the China Osteoporosis Epidemiology Report, the Health Examination Management Measures for Primary and Secondary School Students, the China Degenerative Spine Health Report 2023, as well as relevant provincial and municipal bone health statistics, disease white papers, and reports from related organizations. The search period covered publications from January 2010 to June 2024. The study primarily summarizes the epidemiological characteristics of three major bone-related conditions-osteoporosis, adolescent idiopathic scoliosis, and lumbar disc herniation-and explores associated influencing factors from demographic, socioeconomic, and lifestyle perspectives.

Analysis of 40 studies published between 2010 and 2024 (≈2.1 million participants) shows that osteoporosis affects 4.5% of adults aged 40-49 years, 20.0% of those 50-59 years, and 29.0% of those ≥ 60 years, with prevalence exceeding 40.0% among women aged ≥ 50 years. The national diagnostic rate of adolescent idiopathic scoliosis was 1.2%, rising to 5.6% in high-altitude regions. Lumbar disc herniation occurs in 3.0%, 8.0%, and 11.0% of individuals aged 26-40, 41-60, and≥ 60 years, respectively, and its overall detection rate had increased from 2.0% to 12.0 % in the past decade. Sedentary behaviour, poor nutrition, and inadequate primary-level medical resources collectively drive the high burden of these three conditions.

Osteoporosis, adolescent idiopathic scoliosis, and lumbar disc herniation impose a substantial public health burden in China, highlighting the urgent need to address bone health issues among the key populations of the elderly and the youth. It is recommended to continuously improve the primary-level prevention and control system, enhance early screening, stratified diagnosis, and targeted intervention capabilities, and accelerate the advancement of health education and comprehensive management for high-risk groups.