The US Surgeon General, Richard Carmona, has warned that half of all Americans over the age of 50 will be at risk of fractures from osteoporosis and low bone mass by 2020 unless immediate action is taken.

In his first report on bone health, Carmona said that 34 million more Americans risk developing osteoporosis in addition to the 10 million already suffering from the condition.

It is estimated that 1.5 million people suffer a bone fracture related to osteoporosis each year and the direct care costs for osteoporotic fractures alone are up to $18bn (£9.3bn, 13.4bn euros) a year.

This number is expected to increase if action to prevent osteoporosis is not taken now.

The report claims many people are unaware that their bone health is in danger: one of the most dangerous myths about osteoporosis is that only women need to worry about bone health.

Osteoporosis affects men and women of all races and while bone weakness manifests in older people, strong bones begin in childhood.

“The good news is that you are never too old or too young to improve your bone health. With healthy nutrition, physical activity every day and regular medical check-ups and screenings, Americans of all ages can have strong bones and live longer, healthier lives,” said Carmona.

He is urging individuals, doctors, health systems and policymakers to take action and among his recommendations is the need for daily physically activity; at least for 30 minutes for adults and 60 minutes for children. Exercise should include weight-bearing activities.

“Everyone has a role to play in improving bone health and this report is a starting point for national action on bone health,” said Carmona.

“Let’s get started by taking action today in homes, health care settings and communities across our nation.”

Secretary of the US Department of Health and Human Services, Tommy Thompson, said the report will shape the way the US approaches, talks and acts about bone diseases.