Socioeconomic inequalities in low back pain among older people: the JAGES cross-sectional study
Socioeconomic inequalities in low back pain among older people: the JAGES cross-sectional study
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DOI：
10.1186/s12939-019-0918-1
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发表时间：
2019-01-21
影响因子：
4.8
通讯作者：
Osaka, Ken
中科院分区：
文献类型：
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作者：
Ikeda, Takaaki;Sugiyama, Kemmyo;Osaka, Ken
下背痛是全球重要的公共卫生问题。然而，目前尚不清楚社会经济地位（SES）是否与腰痛有关。本研究使用了2013年日本30个市町村的横断面数据，对老年人中SES与腰痛的关系进行了研究。该调查于2013年10月至2013年12月进行。65岁及以上功能独立的社区居住老年人（n = 26，037）有资格参加这项研究。多水平泊松回归分析与稳健的方差估计被用来检查SES和腰痛之间的关联。过去一年中自我报告的腰痛被用作因变量。教育程度，过去的职业，相当于家庭收入，财富和主观经济状况代表SES，并分别作为自变量进行分析，调整协变量，包括年龄和性别。腰痛的患病率为63.4%。总的来说，较低的社会经济地位比最高的更容易遭受腰痛。首先，关于教育程度，最低水平的患病率（PR）（95%可信区间（CI））为1.07（1.02-1.12）。第二，就过去职业而言，蓝领工人与专业人员相比的PR（95%CI）为1.06（1.01-1.11）。第三，在家庭收入均等化方面，中下收入和最低收入的PR（95%CI）分别为1.08（1.02-1.13）和1.16（1.10-1.23）。第四，就财富而言，中低和最低财富水平的PR（95%CI）分别为1.11（1.04-1.19）和1.18（1.11-1.27）。第五，在主观经济状况方面，中下经济状况和最低经济状况的PR（95%CI）分别为1.18（1.10-1.26）和1.32（1.22-1.44）。政策制定者和临床医生必须了解这些不平等的性质。
Low 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.We 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.The 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.Significant socioeconomic inequalities were observed in low back pain among older individuals in Japan. Policymakers and clinicians must understand the nature of these inequalities.