Back problems, comorbidities, and their association with wealth

Deborah J Schofield; Emily J Callander; Rupendra N Shrestha; Megan E Passey; Simon J Kelly; Richard Percival

doi:10.1016/j.spinee.2014.06.018

Back problems, comorbidities, and their association with wealth

Spine J. 2015 Jan 1;15(1):34-41. doi: 10.1016/j.spinee.2014.06.018. Epub 2014 Jul 4.

Authors

Deborah J Schofield¹, Emily J Callander², Rupendra N Shrestha³, Megan E Passey⁴, Simon J Kelly⁵, Richard Percival⁵

Affiliations

¹ NHMRC Clinical Trials Centre, University of Sydney, 92-94 Parramatta Rd, Camperdown, Sydney NSW 1450, Australia; School of Public Health, University of Sydney, Edward Ford Building (A27), NSW 2050, Australia.
² NHMRC Clinical Trials Centre, University of Sydney, 92-94 Parramatta Rd, Camperdown, Sydney NSW 1450, Australia. Electronic address: emily.callander@sydney.edu.au.
³ NHMRC Clinical Trials Centre, University of Sydney, 92-94 Parramatta Rd, Camperdown, Sydney NSW 1450, Australia.
⁴ University Centre for Rural Health-North Coast, 55-61 Uralba St, Lismore NSW 2480, Australia.
⁵ National Centre for Social and Economic Modelling, University of Canberra, Canberra ACT 2601, Australia.

PMID: 25007754
DOI: 10.1016/j.spinee.2014.06.018

Abstract

Background context: Studies assessing the economic burden of back problems have given little consideration to the presence of comorbidities.

Purpose: To assess the difference in the value of wealth held by Australians who have back problems and varying numbers of chronic comorbidities.

Study design: A cross-sectional study.

Patient sample: Individuals aged 45 to 64 years in 2009: 4,388 with no chronic health conditions, 1,405 with back problems, and 3,018 with other health conditions.

Outcome measure: Total wealth (cash, shares, superannuation, investment property, and owner occupied home).

Methods: Using a microsimulation model (Health&WealthMOD), logistic regression models were used to assess the odds of having any wealth. Linear regression models were used to assess the difference in the value of this wealth.

Results: Those with back problems and two comorbidities had 0.16 (95% confidence interval [CI]: 0.06-0.42) times the odds and those with back problems and three or more comorbidities had 0.20 (95% CI: 0.11-0.38) times the odds of having accumulated some wealth than those with no chronic health conditions. Those with back problems and three or more comorbidities had a median value of total wealth of around $150,000, whereas those with back problems only and back problems and one comorbidity had a median value of total wealth of around $250,500. There was no significant difference in the amount of wealth accumulated by those with back problems and at least one comorbidity and those with other health conditions and the same number of comorbidities. However, those with only one health condition (excluding back problems) had 65% more wealth than those with back problems only (95% CI: 5.1-161.2).

Conclusions: This study highlights the importance of considering multiple morbidities when discussing the relationship between back problems and economic circumstances.

Keywords: Australia; Back problems; Comorbidity; Cost of illness; Economic resources; Wealth.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Australia
Back Pain / complications
Back Pain / economics*
Back Pain / epidemiology
Chronic Disease
Comorbidity*
Cost of Illness*
Cross-Sectional Studies
Female
Healthcare Disparities / statistics & numerical data*
Humans
Logistic Models
Male
Middle Aged
Socioeconomic Factors