Syndemic and syndemogenesis of low back pain in Latin-American population: a network and cluster analysis.

INTRODUCTION: Although low back pain (LBP) is a high-impact health condition, its burden has not been examined from the syndemic perspective. OBJECTIVE: To compare and assess clinical, socioeconomic, and geographic factors associated with LBP prevalence in low-income and upper-middle-income countries using syndemic and syndemogenesis frameworks based on network and cluster analyses. METHODS: Analyses were performed by adopting network and cluster design, whereby interrelations among the individual and social variables and their combinations were established. The required data was sourced from the databases pertaining to the six Latin-American countries. RESULTS: Database searches yielded a sample of 55,724 individuals (mean age 43.38 years, SD = 17.93), 24.12% of whom were indigenous, and 60.61% were women. The diagnosed with LBP comprised 6.59% of the total population. Network analysis showed higher relationship individuals' variables such as comorbidities, unhealthy habits, low educational level, living in rural areas, and indigenous status were found to be significantly associated with LBP. Cluster analysis showed significant association between LBP prevalence and social variables (e.g. Gender inequality Index, Human Development Index, Income Inequality). CONCLUSIONS: LBP is a highly prevalent condition in Latin-American populations with a high impact on the quality of life of young adults. It is particularly debilitating for women, indigenous individuals, and those with low educational level, and is further exacerbated by the presence of comorbidities, especially those in the mental health domain. Thus, the study findings demonstrate that syndemic and syndemogenesis have the potential to widen the health inequities stemming from LBP in vulnerable populations. Key points • Syndemic and syndemogenesis evidence health disparities in Latin-American populations, documenting the complexity of suffering from a disease such as low back pain that is associated with comorbidities, unhealthy habits, and the social and regional context where they live. • The use of network and cluster analyses are useful tools for documenting the complexity and the multifaceted impact in health in large populations as well as the differences between countries. • The variability and impact of socioeconomic indicators (e.g., Gini index) related to low back pain and comorbidities could be felt through the use of cluster analysis, which generates evidence of regional inequality in Latin America. • Populations can be studied from different models (network and cluster analysis) and grouping, presenting new interpretations beyond geographical groupings, such as syndemic and inequity in health.

Prevalence of back pain in the community. A COPCORD-based study in the Mexican population.

OBJECTIVE: Back pain (BP) is frequent in the community; its prevalence in México is 6%. Our objective was to determine the prevalence of BP in Mexican communities and determine its most important characteristics. METHODS: A cross-sectional study of individuals aged > 18 years was conducted in Mexico City and in urban communities in the state of Nuevo León. Sampling in Mexico City was based on community census and in Nuevo León, on stratified, balanced, and random sampling. Procedures included a door-to-door survey, using the Community Oriented Program for the Control of Rheumatic Diseases, to identify individuals with BP > 1 on a visual analog scale in the last 7 days. General practitioners/rheumatology fellows confirmed and characterized BP symptoms. RESULTS: In all, 8159 individuals (mean age 43.7 yrs, two-thirds female) were surveyed and 1219 had BP. The prevalence of nontraumatic BP in the last 7 days was 8.0% (95% CI 7.5-8.7). The mean age of these individuals was 42.7 years, and 61.9% were female. Thirty-seven percent had inflammatory BP [prevalence of 3.0% (95% CI 2.7-3.4)]. Compared with the state of Nuevo Léon, the characteristics and consequences of BP in Mexico City were more severe. In logistic regression analysis, living in Mexico City, having a paid job, any kind of musculoskeletal pain, high pain intensity, and obesity among other variables were associated with BP. CONCLUSION: The prevalence of nontraumatic BP in the last 7 days in urban communities in México is 8.0%. However, clinical features and consequences differed among the communities studied, suggesting a role for local factors in BP.