The contextual effect of area-level unemployment rate on lower back pain: A multilevel analysis of three consecutive surveys of 962,586 workers in Japan

Takaaki Ikeda, Kemmyo Sugiyama, Jun Aida, Toru Tsuboya, Ken Osaka

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

This study examined the associations between area-level unemployment rates and lower back pain using large-scale data provided by the Japanese working population. We analyzed data from a nationally representative, repeated, cross-sectional study across three waves from 2010, 2013, and 2016 in 47 Japanese subnational level areas. Workers aged 18–64 years (n = 962,586) were eligible to participate in the study. A multilevel logistic model was used to examine the association between the unemployment rate and lower back pain. The self-report of lower back pain was a dependent variable. The prefecture-level unemployment rate was analyzed as an independent variable, adjusted for individual-level covariates (e.g., gender, age, socioeconomic status). After adjusting for all covariates, the main effect of the prefecture-level unemployment rate was statistically significant: the odds ratio (OR) (95% credible interval (CrI)) was 1.01 (1.002, 1.03). Additionally, the OR (95% CrI) for the interaction between gender and the prefecture-level unemployment rate was 1.02 (1.01, 1.03) indicating that women were more affected by area-level employment status than men. In conclusion, a significant association between the unemployment rate and lower back pain was observed in the Japanese working population. Women were more sensitive to the unemployment rate.

Original languageEnglish
Article number4016
JournalInternational journal of environmental research and public health
Volume16
Issue number20
DOIs
Publication statusPublished - 2019 Oct 2

Keywords

  • Bayesian approach
  • E-value
  • Education
  • Occupation
  • Socioeconomic status
  • Spillover effect
  • Unemployment rate

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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