Abstract
This study examined a cross-sectional association between self-reported low back pain (LBP) and unemployment among working-age people, and estimated the impact of self-reported LBP on unemployment. We used anonymized data from a nationally representative survey (24,854 men and 26,549 women aged 20–64 years). The generalized estimating equations of the multivariable Poisson regression models stratified by gender were used to estimate the adjusted prevalence ratio (PR) and 95% confidence interval (CI) for unemployment. The population attributable fraction (PAF) was calculated using Levin’s method, with the substitution method for 95% CI estimation. The prevalence of self-reported LBP was 9.0% in men and 11.1% in women. The prevalence of unemployment was 9.3% in men and 31.7% in women. After adjusting for age, socio-economic status, lifestyle habits, and comorbidities, the PR (95% CI) for the unemployment of the LBP group was 1.32 (1.19–1.47) in men and 1.01 (0.96–1.07) in women, compared with the respective non-LBP group. The PAF (95% CI) of unemployment associated with self-reported LBP was 2.8% (1.6%, 4.2%) in men. Because the total population of Japanese men aged 20–64 in 2013 was 36,851 thousand, it was estimated that unemployment in 1037 thousand of the Japanese male working population was LBP-related.
Highlights
Published: 13 October 2021The Global Burden of Disease Study 2016 reported that low back pain (LBP) has become the leading cause of years lived with disability [1]
We quantified the importance of unemployment associated with self-reported LBP as a public health issue by estimating the population attributable fraction (PAF) and found that self-reported LBP accounted for 2.8% of unemployed men aged 20 through 64 years
Our results are consistent with previous studies, showing that self-reported LBP is associated with unemployment [12,13,31]
Summary
The Global Burden of Disease Study 2016 reported that low back pain (LBP) has become the leading cause of years lived with disability [1]. In Japan, musculoskeletal disorders, including LBP, account for 7.7% of the total medical expenses (about JPY 2.3 trillion) in 2016, ranking third after cardiovascular diseases and neoplasms [2]. According to a recent report in the United States, the annual cost of LBP in 2016 was an estimated USD 134.5 billion of the total healthcare spending [3]. According to a systematic review on the overall costs associated with LBP, indirect costs (sick leave, early retirement, lost household productivity, and presenteeism, etc.) are estimated to be approximately six times higher than direct medical costs [4]. LBP is considered to be a major global health problem
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