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.

随着我国人口老龄化程度不断加深及青少年健康问题日益凸显，骨健康问题已成为影响国民健康与生活质量的重要因素。党的二十大报告提出"实施积极应对人口老龄化国家战略"，《"健康中国2030"规划纲要》倡议开展"健康骨骼专项行动"。

针对我国基层地区"一老一小"重点人群的骨健康代表性病种（骨质疏松症、青少年特发性脊柱侧凸、腰椎间盘突出症），分析其流行病学现状及影响因素，为国家及地方卫生政策制定提供科学依据。

依托中国工程院战略研究与咨询项目，全面检索中国知网、PubMed、WHO、Embase、Cochrane Library数据库公开发表的文献，重点关注近年发布的《国家卫生健康统计年鉴》《中国骨质疏松流行病学调查报告》《中小学生健康体检管理办法》《中国退行性脊柱健康报告2023》及各省市骨健康相关统计资料，疾病白皮书与相关组织报告，检索时间为2010年1月—2024年6月。重点针对骨质疏松症、青少年特发性脊柱侧凸、腰椎间盘突出症三类疾病的流行病学特征进行汇总，并从人口学、社会经济学、生活方式等多角度探讨影响因素。

纳入2010—2024年40篇研究（≈210万例）显示：骨质疏松症患病率在40~49岁、50~59岁和≥60岁分别为4.5%、20.0%和29.0%，≥50岁女性>40.0%；青少年特发性脊柱侧凸全国确诊率1.2%，高海拔地区可至5.6%；腰椎间盘突出症在26~40岁、41~60岁和≥60岁人群中为3.0%、8.0%和11.0%，近十年总体检出率由2.0%升至12.0%。久坐少动、营养不足和基层医疗资源不足等因素共同促成三病高发。

我国骨质疏松症、青少年特发性脊柱侧凸及腰椎间盘突出症公共卫生负担沉重，"一老一小"重点人群的骨健康问题亟需重视。建议持续完善基层防控体系，持续增强早期筛查、分类诊断、精准干预能力，加速提升高危人群健康教育及全程管理水平。