Socioeconomic inequalities in low back pain among older people: the JAGES cross-sectional study

Takaaki Ikeda; Kemmyo Sugiyama; Jun Aida; Toru Tsuboya; Nanae Watabiki; Katsunori Kondo; Ken Osaka

doi:10.1186/s12939-019-0918-1

Socioeconomic inequalities in low back pain among older people: the JAGES cross-sectional study

Int J Equity Health. 2019 Jan 21;18(1):15. doi: 10.1186/s12939-019-0918-1.

Authors

Takaaki Ikeda^{1

2}, Kemmyo Sugiyama³, Jun Aida², Toru Tsuboya², Nanae Watabiki⁴, Katsunori Kondo^{5

6}, Ken Osaka²

Affiliations

¹ Department of Rehabilitation, Physical Therapy, Sendai Seiyo Gakuin Junior College, Sendai, Japan.
² Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
³ Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. ksugiyama@med.tohoku.ac.jp.
⁴ Sendai Pain Clinic Center, Sendai, Japan.
⁵ Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.
⁶ Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.

Abstract

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.

Keywords: Educational attainment; Health inequalities; Income; Low back pain; Occupation; Socioeconomic status; Subjective economic situation.

Publication types

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

MeSH terms

Aged
Aged, 80 and over
Cross-Sectional Studies
Female
Humans
Japan / epidemiology
Low Back Pain / epidemiology*
Male
Middle Aged
Poverty*
Prevalence
Self Report
Social Class
Socioeconomic Factors*
Surveys and Questionnaires