Does socioeconomic status in adolescence predict low back pain in adulthood? A repeated cross-sectional study of 4,771 Danish adolescents

Abstract

Social and economic disadvantage is associated with general poor physical health. This relationship has been recognised for centuries, but it is unknown whether socioeconomic factors have a specific influence on low back pain (LBP). Furthermore, it is unknown how social and economic disadvantages in youth affect adult health. Therefore, the specific objectives of this study are to explore (1) the cross-sectional association between socioeconomic status (SES) and LBP in adolescence and (2) the longitudinal association between SES in adolescence and LBP in early adulthood. A database containing LBP data from 4,771 twins was merged with their parents' social and economic data, available from Statistics Denmark. Low back pain data ['any low back pain' and 'persistent low back pain (more than 30 days)'] were collected in 1994, when the subjects were 12-18 years of age, and collected again eight years later. Socioeconomic data of the parents (education, income, social class and long-term illness, all for both mother and father) were collected in 1994. Logistic regression analyses were used to estimate the associations between each parameter of parental SES in adolescence and LBP at baseline as well as at follow-up. Finally, the influence of a variable combining the different socioeconomic parameters was established. All estimates were controlled for smoking, alcohol consumption and body mass index at baseline. In the logistic regression models, only three of the 32 estimates were statistically significant. When merging the socioeconomic variables into a combined score, the results indicated that a good social background had a protective effect against the persistent LBP, while there was no association with any LBP. However, the statistical significance of this effect was unclear. We found no or very weak indications of possible relationships between social factors in adolescence and LBP at baseline and at follow-up.

Low back pain associated with sociodemographic factors, lifestyle and osteoporosis: A population-based study

“…That social and economic disadvantage associated with generally poorer physical health has been recognized for centuries. Marital status, education, occupation, and income level also specifically influence LBP (32,33), with previous research noting the opposite association between education and LBP risk (33). Compared with less-educated people, highly educated people tend to work in jobs with a lower risk of LBP, and also may have more knowledge about coping with or preventing LBP; the unemployed also had a lower risk of LBP (33).…”

Effects of workplace, family and cultural influences on low back pain: What opportunities exist to address social factors in general consultations?

“…Studies of socioeconomic status and LBP (including income, education and occupation) have also had mixed results. There are frequent reports that lower income, less education and employment in manual occupations is associated with increased pain and disability [60,61,[66][67][68][69], but other studies report no associations [64,65,68,70]. There is very little research examining the association between race/ethnicity and LBP.…”

Acute low back pain in high school adolescents in Southern Brazil: prevalence and associated factors

“…During the last two decades, many aspects as anthropometry, psychosocial, age, gender, smoking, screen time, computer use, backpacks and school furniture, physical activity, working, genetics and socioeconomic status have been associated with LBP in adolescents [5,6]. Age is especially relevant as associated factors and occurrence change across age groups [7].…”