A public health planner must allocate funding to reduce population-level osteoporosis risk over the next 50 years. Which integrated approach synthesizes the strongest evidence-based elements for long-term impact?

Allocate funds exclusively to distribute free calcium pills to seniors, because improving intake late in life is sufficient to reverse decades of bone loss and no other interventions are necessary.

Provide universal long-term hormone replacement therapy to all postmenopausal women in the population without screening or counseling about risks and benefits because estrogen is the single most powerful agent to prevent fractures.

Invest in school nutrition programs to ensure adequate calcium and vitamin D for children and adolescents, fund community-based resistance/weight-bearing exercise programs across the lifespan, and support screening plus targeted pharmacotherapy for high-risk older adults.

Focus spending solely on research to develop gene therapies for osteoporosis and delay any community-level nutritional or exercise programs until the gene therapy is available.