[Social inequalities in the prevalence of chronic back pain among adults in Germany]. / Soziale Ungleichheit und chronische Rückenschmerzen bei Erwachsenen in Deutschland.

ABSTRACT

BACKGROUND: Back pain is a common cause for health care utilization and inability to work and associated with corresponding costs. The aim of the study was to investigate socioeconomic inequalities in chronic back pain in the adult general population. METHODS: The analyses were based on pooled data of three waves (2009, 2010, 2012) of the nationwide German Health Update (GEDA) study carried out by the Robert Koch Institute (n = 62,606 aged 18 years and older). Self-reported back pain symptoms persisting at least three months were used to determine lifetime and 12-month prevalence. For analyzing socioeconomic differences in the prevalence of chronic back pain, a multidimensional SES index and its three individual components - educational level, occupational status and income - were used. RESULTS: About every sixth man (17.1%) and every fourth woman (24.4%) reported chronic back pain in the past twelve months. With decreasing SES, the 12-month prevalence of chronic back pain increased (Relative Index of Inequality (RII) [95% CI], men = 2.29 [2.04-2,56], women=1.92 [1.76-2.09]). Similar results were observed for lifetime prevalence. For both men and women, educational level, occupational status and income each had independent effects on chronic back pain prevalence. CONCLUSION: In Germany, back pain is widely prevalent. Our finding that different aspects of SES are independently associated with chronic back pain prevalence is a challenge but also a chance for treatment and preventive strategies combining behavioral and setting-oriented measures.