TY - JOUR
T1 - Socioeconomic inequalities in low back pain among older people
T2 - The JAGES cross-sectional study
AU - Ikeda, Takaaki
AU - Sugiyama, Kemmyo
AU - Aida, Jun
AU - Tsuboya, Toru
AU - Watabiki, Nanae
AU - Kondo, Katsunori
AU - Osaka, Ken
N1 - Funding Information:
This study was supported by a grant of the Strategic Research Foundation Grant-aided Project for Private Universities from the Ministry of Education, Culture, Sport, Science, and Technology, Japan, 2009–2013, for the Center for Well-being and Society, Nihon Fukushi University, Grants-in-Aid for Scientific Research (22330172, 22390400, 22390400, 22592327, 23243070, 23590786, 23790710, 24390469, 24530698, 24653150, 24683018, 25253052, 25870573, 25870881, 26285138, 26882010, 15H04781, 15H01972, 16H05556, 16 K19267) from the Japan Society for the Promotion of Science. The study was also supported by a Health and Labour Sciences Research Grant, and grants for Comprehensive Research on Aging and Health (H22-Choju-Shitei-008, H24-Junkankitou-Ippan-007, H24-Chikyukibo-Ippan-009, H24-Choju-Wakate-009, H25-Kenki-Wakate-015, H25-Irryo-Shitei-003 [Fukkou], H26-Choju-Ippan-006, H27-Ninchisyou-Ippan-001, H28-Choju-Ippan-002) from the Ministry of Health, Labour and Welfare, Japan, the Research and Development Grants for Longevity Science from AMED (Japan Agency for Medical Research and development, the Personal Health Record (PHR) Utilization Project from AMED, World Health Organization Centre for Health Development (WHO Kobe Centre), (WHO APW 2017/713981), Japan Foundation for Aging and Health Research Support Grant, a grant from The Health Care Science Institute, as well as grants from National Center for Geriatrics and Gerontology. The research funding bodies had no role in the study design, data collection, data analysis, data interpretation, writing, or submitting of the report.
Publisher Copyright:
© 2019 The Author(s).
PY - 2019/1/21
Y1 - 2019/1/21
N2 - Background: 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. Methods: 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. Results: 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. Conclusions: Significant socioeconomic inequalities were observed in low back pain among older individuals in Japan. Policymakers and clinicians must understand the nature of these inequalities.
AB - Background: 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. Methods: 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. Results: 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. Conclusions: Significant socioeconomic inequalities were observed in low back pain among older individuals in Japan. Policymakers and clinicians must understand the nature of these inequalities.
KW - Educational attainment
KW - Health inequalities
KW - Income
KW - Low back pain
KW - Occupation
KW - Socioeconomic status
KW - Subjective economic situation
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U2 - 10.1186/s12939-019-0918-1
DO - 10.1186/s12939-019-0918-1
M3 - Article
C2 - 30665404
AN - SCOPUS:85060260310
SN - 1475-9276
VL - 18
JO - International Journal for Equity in Health
JF - International Journal for Equity in Health
IS - 1
M1 - 15
ER -
