Abstract
The objective was to analyze the epidemiological characteristics of chronic back problems in Brazil and study the association between their prevalence and demographic and socioeconomic factors, lifestyle, and health conditions. The study used micro-data from the Brazilian National Health Survey (PNS), 2013. The epidemiological indicators were: prevalence, time with chronic back problems, life cycle (from young adults to the elderly), limitations in activities of daily living, and mean age at onset of symptoms, according to sex and age bracket. In order to analyze inequality in chronic back problems according to socioeconomic characteristics and risk factors, a multivariate logistic regression model was used, based on life cycle stages, with the presence of chronic back problems as the dependent variable and the following independent variables: sex, schooling, area of residence, race/color, self-rated health, types of chronic diseases, body mass index (BMI), and physical activity. Prevalence of chronic back problems in Brazil was 18.5%, and was higher in women than in men (21.1%; 95%CI: 20.2-21.9). Mean age at onset of chronic back problems was 35 years. There was an association between chronic back problems and lower schooling, poor self-rated health, and presence of the majority of the selected chronic diseases. Area of residence, BMI, age, and race/color were weakly associated or not associated with chronic back problems. Prevalence of chronic back problems stabilized at 50 years of age, but the severity of limitations increased at older ages. As in other countries, high prevalence and the impact on living conditions revealed the need for epidemiological studies on chronic back problems in Brazil. The results suggest that health promotion and the prevention of chronic back problems should be intensified, especially before 50 years of age, considering the on-going population aging in Brazil.
Highlights
Chronic back problems may not be potentially fatal, but they are an important public health [1,2,3], economic, and social problem [4,5]
As for health, fewer than 50% had adequate weight, approximately 69% rated their health as good or very good, 21% had been diagnosed with hypertension, and less than 10% had any other of the chronic diseases included in the analysis
The prevalence of chronic back problems (18.5%) indicates that some 25 million Brazilians 18 years and older suffer from this condition
Summary
Chronic back problems may not be potentially fatal, but they are an important public health [1,2,3], economic, and social problem [4,5]. As shown by the Global Burden of Disease study in 2010, held in 47 countries, chronic back problems are the leading cause of years of life lost to disability 7. Variations in prevalence in systematic reviews [2,4,9,10,11] are due largely to difficulties in the precise anatomical-pathological diagnosis of the condition, variability in anatomical site (lumbar, back, or other), relevance of symptoms (such as pain) for definition of chronicity, and differences in the reference period for back problems in survey questions (days, months, or the previous year). Chronicity of back problems is generally defined as continuous pain for at least three months, regardless of possible limitations caused by the problem 8
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