The Geography of Pain in the United States and Canada.

The Geography of Pain in the United States and Canada.
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DOI:
10.1016/j.jpain.2022.08.002
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发表时间:
2022-12
期刊:
影响因子:
4
通讯作者:
Grol-Prokopczyk, Hanna
Grol-Prokopczyk, Hanna
中科院分区:
医学2区
文献类型:
--
作者:
Zajacova, Anna;Lee, Jinhyung;Grol-Prokopczyk, Hanna

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到目前为止,疼痛流行病学家很少关注疼痛的地理空间分析。尽管地理比较可以揭示增加或减轻疼痛的社会因素,但对疼痛的跨国差异,特别是国家以下的差异都没有得到充分的研究。这项研究首次对美国和加拿大的疼痛进行了比较分析,比较了两国的总体情况,同时还分析了各州和各省之间的差异。分析基于2020年从美国和加拿大18岁及以上成年人(N = 4,113)中收集的横断面数据。局灶性疼痛测量是疼痛频率和疼痛干扰的产物。我们使用分解和回归分析将社会经济特征和疼痛联系起来,并使用反距离加权空间插值来绘制疼痛水平。我们发现美国的疼痛程度明显高于加拿大。这种差异部分与美国人更糟糕的经济状况有关。此外,我们在美国和加拿大发现了显著的疼痛变异性。美国南部腹地、阿巴拉契亚和西部部分地区是疼痛“热点”,疼痛程度特别高。总的来说,我们的研究结果确定了高度需要疼痛预防和管理的领域;他们还敦促进一步研究地理因素作为人群疼痛的重要协变量。这项研究记录了美国与加拿大的高疼痛负担,并指出深南部,阿巴拉契亚和西部部分地区的州具有特别高的疼痛负担。研究结果确定了高度需要疼痛预防和管理的地理区域。
Pain epidemiologists have, thus far, devoted scant attention to geospatial analyses of pain. Both cross-national and, especially, subnational variation in pain have been under-studied, even though geographic comparisons could shed light on social factors that increase or mitigate pain. This study presents the first comparative analysis of pain in the U.S. and Canada, comparing the countries in aggregate, while also analyzing variation across states and provinces. Analyses are based on cross-sectional data collected in 2020 from U.S. and Canadian adults 18 years and older (N = 4,113). The focal pain measure is a product of pain frequency and pain interference. We use decomposition and regression analyses to link socioeconomic characteristics and pain, and inverse-distance weighting spatial interpolation to map pain levels. We find significantly and substantially higher pain in the U.S. than in Canada. The difference is partly linked to Americans’ worse economic conditions. Additionally, we find significant pain variability within the U.S. and Canada. U.S. states in the Deep South, Appalachia, and parts of the West stand out as pain ‘hotspots’ with particularly high pain levels. Overall, our findings identify areas with a high need for pain prevention and management; they also urge further scholarship on geographic factors as important covariates in population pain. This study documents the high pain burden in the U.S. versus Canada, and points to states in the Deep South, Appalachia, and parts of the West as having particularly high pain burden. The findings identify geographic areas with a high need for pain prevention and management.
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