We used the Research Patient Data Registry (RPDR), a research and administrative data source designed to identify patients who meet specified criteria through a query tool. The Human Studies Institutional Review Board (IRB) committee of Partners HealthCare System approved the study protocol. Exploration of the process of ordering the test or determining why patients get the test is beyond the scope of this study. The goal of this study was to evaluate treatment of vitamin D deficiency (25OHD < 20 ng/ml) in a racially diverse ambulatory practice affiliated with an academic urban medical center to determine the presence of racial/ethnic or sex disparities in use of vitamin D supplementation. To date, limited data on sex, racial and ethnic differences in vitamin D prescribing for vitamin D deficiency exist. 28 Furthermore, vitamin D supplementation can prevent and treat vitamin D deficiency. 27 Higher levels may be needed to provide extraskeletal benefits. Although the desirable 25OHD range for patients needs to be more accurately defined, the Institute of Medicine (IOM) recommends 25OHD above 20 ng/ml to ensure that 97.5% of the population are vitamin D replete for optimal bone health. Serum 25OHD is a reliable method for evaluating vitamin D stores in patients. 24– 26 As a result, 25OHD levels represent an important health issue in this group. 21– 23 Overall, blacks have 25OHD levels that tend to be one-third to one-half those of whites. 18– 20 Furthermore, the risk of all-cause mortality is inversely related to 25OHD level. 14– 17 Higher healthcare costs associated with vitamin D deficiency are linked with increased length of hospital stay, surgical intensive care unit cost and mortality rate. 1, 2 Vitamin D deficiency is associated with a myriad of costly diseases including fractures 3– 7, sepsis 8– 13, and cancer. Vitamin D deficiency, defined as 25-hydroxyvitamin D (25OHD) level less than 20 ng/ml, is widespread due to low dietary intake, supplement use and sun avoidance.

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