Abstract
BackgroundLow back pain is an important public health issue across the world. However, it is unclear whether socioeconomic status (SES) is associated with low back pain. This study determines an association between SES and low back pain among older people.MethodsWe used cross-sectional data derived from the year 2013 across 30 Japanese municipalities. The survey was conducted between October 2013 to December 2013. Functionally independent community-dwelling older adults aged 65 and above (n = 26,037) were eligible for the study. Multilevel Poisson regression analysis with a robust variance estimator was used to examine the association between SES and low back pain. Self-reported low back pain in the past year was used as a dependent variable. Educational attainment, past occupation, equivalized household income, wealth, and subjective economic situation represented SES and were separately analyzed as independent variables, adjusted for covariates including age and sex.ResultsThe prevalence of low back pain was 63.4%. Overall, lower SES were more likely to suffer from low back pain compared with that for the highest. First, as for the educational attainment, the prevalence ratio (PR) (95% credible interval (CI)) for the lowest level was 1.07 (1.02–1.12). Second, as for the past occupation, the PR (95% CI) for the blue-collared workers compared with professionals was 1.06 (1.01–1.11). Third, as for the equalized household income, the PRs (95% CI) for lower middle and the lowest income levels were 1.08 (1.02–1.13) and 1.16 (1.10–1.23), respectively. Fourth, as for the wealth, the PRs (95% CI) for lower middle and the lowest wealth levels were 1.11 (1.04–1.19) and 1.18 (1.11–1.27), respectively. Fifth, as for the subjective economic situation, the PRs (95% CI) for lower middle and the lowest financial conditions were 1.18 (1.10–1.26) and 1.32 (1.22–1.44), respectively.ConclusionsSignificant socioeconomic inequalities were observed in low back pain among older individuals in Japan. Policymakers and clinicians must understand the nature of these inequalities.
Highlights
Low back pain is the number one cause of disability [1]
The prevalence of low back pain in the past year was 63.4% in the complete data. (Additional file 1: Table S2) Those who were older, female, living alone, less educated, lower income level and with lower wealth were more likely to suffer from low back pain in the past year (Table 1)
As for educational attainment, after adjusting for covariates and risk factors (Model 3), those of the lowest educational level were more likely to experience low back pain compared with the highest educational level–a prevalence ratio (PR) (95% credible interval (CI)) of 1.07 (1.02, 1.12)
Summary
Low back pain is the number one cause of disability [1]. It is most commonly experienced among musculoskeletal pains for all age groups [2, 3]. Various studies reported socioeconomic inequalities in the risk factors of low back pain [13,14,15,16] such as depression [17], obesity [18], and smoking [18]. The results of previous studies on socioeconomic status (SES) and low back pain have been inconsistent. Another cross-sectional study from France reported that there was no association between educational attainment and low back pain [19]. We conducted a cross-sectional study to determine the association of past and present SES with low back pain among older Japanese people. Low back pain is an important public health issue across the world It is unclear whether socioeconomic status (SES) is associated with low back pain. This study determines an association between SES and low back pain among older people
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