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.
Similar content being viewed by others
References
Macleod J, Smith GD (2003) Psychosocial factors and public health: a suitable case for treatment? J Epidemiol Community Health 57:565–570
Smith GD, Carroll D, Rankin S, Rowan D (1992) Socioeconomic differentials in mortality: evidence from Glasgow graveyards. Br Med J 305:1554–1557
Adler NE, Boyce T, Chesney MA, Folkman S, Syme L (1993) Socioeconomic inequalities in health: no easy solution. JAMA 269:3140–3145
Lynch JW, Smith GD, Kaplan GA, House JS (2000) Income inequality and mortality: importance to health of individual income, psychosocial environment or material conditions. Br Med J 320:1200–1204
Williams DR, Collins C (1995) US socioeconomic and racial differences in health: patterns and explanations. Annu Rev Sociol 21:349–386
Larsen K, Leboeuf-Yde C (2006) Coping and backproblems: a prospective observational study of Danish military recruits. J Manipulative Physiol Ther 29:619–625
Leboeuf-Yde C, Larsen K, Ahlstrand I, Volinn E (2006) Coping and back problems: analysis of multiple data sources on an entire cross-sectional cohort of Swedish military recruits. BMC Musculoskeletal Disord 7:39
Leino-Arjas P, Kaila-Kangas L, Keskimäki I, Notkola V, Mutanen P (2002) Inpatient hospital care for lumbar disc disorders in Finland in relation to education, occupational class, income, and employment. Public Health 116:272–278
Papageorgiou AC, Macfarlane GJ, Thomas E, Croft PR, Jayson MI, Silman AJ (1997) Psychosocial factors in the workplace—do they predict new episodes of low back pain? Evidence from the South Manchester Back Pain Study. Spine 22:1137–1142
Khatun M, Ahlgren C, Hammarström A (2004) The influence of factors identified in adolescence and early adulthood on social class inequities of musculoskeletal disorders at age 30: a prospective population-based cohort study. Int J Epidemiol 33:1353–1360
Leboeuf-Yde C, Wedderkopp N, Andersen LB, Froberg K, Hansen HS (2002) Back pain reporting in children and adolescents: the impact of parents’ educational level. J Manipulative Physiol Ther 25:212–220
Sjolie AN (2002) Psychosocial correlates of low-back pain in adolescents. Eur Spine J 11:582–588
Kristensen PL, Wedderkopp N, Moller NC, Andersen LB, Bai CN, Froberg K (2006) Tracking and prevalence of cardiovascular disease risk factors across socio-economic classes: a longitudinal substudy of the European Youth Heart Study. BMC Public Health 27:6–20
Lehman BJ, Taylor SE, Kiefe CI, Seeman TE (2005) Relation of childhood socioeconomic status and family environment to adult metabolic functioning in the CARDIA study. Psychosom Med 67:846–854
Poulton R, Caspi A, Milne BJ, Thomson WM, Taylor A, Sears MR, Moffitt TE (2002) Association between children’s esperience of socioeconomic disadvantage and adult health: a life-course study. Lancet 360:1640–1645
Laaksonen M, Rahkonen O, Martikainen P, Lahelma E (2005) Socioeconomic position and self-rated health: the contribution of childhood circumstances, adult socioeconomic status, and material resources. Am J Public Health 95:1403–1409
Harper S, Lynch J, Hsu WL, Everson SA, Hillemeier MM, Raghunathan TE et al (2002) Life course socioeconomic conditions and adults psyhosocial functioning. Int J Epidemiol 31:395–403
Gallo LC, Matthews KA (2003) Understanding the association between socioeconomic status and physical health: do negative emotions play a role? Psychol Bull 129:10–51
Christensen K, Vaupel J, Holm NV et al (1995) Twin mortality after age 6: fetal origins hypothesis versus twin method. Br Med J 310:432–436
Kyvik KO, Green A, Beck-Nielsen H (1995) Concordance rates of insulin dependent diabetes melitus: a population based study of young Danish twins. Br Med J 311:913–917
Bryld LE, Agner T, Kyvik KO et al (2000) Hand eczema in twins: a questionnaire investigation. Br J Dermatol 142:298–305
Skadhauge LR (1999) Genetic and environmental influence on asthma. A population based study of Danish twins. Ph.D. thesis, University of Southern Denmark, Odense, Denmark
Hestbaek L (2003) The natural course of low back pain and early identification of high-risk populations. Ph.D. thesis, University of Southern Denmark, Odense, Denmark
Kyvik KO, Christensen K, Skytthe A et al (1996) The Danish Twin Register. Dan Med Bull 43:467–470
Kuorinka I, Jonsson B, Kilbom A et al (1987) Standardized Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 18:233–237
Biering-Soerensen F, Hilden J (1984) Reproducibility of the history of back trouble. Spine 9:280–286
Hestbaek L, Leboeuf-Yde C, Kyvik KO et al (2004) Comorbidity with low back pain. A cross-sectional population-based survey of 12–22 year olds. Spine 29:1483–1491
Hestbaek L, Leboeuf-Yde C, Kyvik KO, Manniche C (2006) The course of low back pain from adolescence to adulthood: eight-year follow-up of 9,600 twins. Spine 31:468–472
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hestbaek, L., Korsholm, L., Leboeuf-Yde, C. et al. Does socioeconomic status in adolescence predict low back pain in adulthood? A repeated cross-sectional study of 4,771 Danish adolescents. Eur Spine J 17, 1727–1734 (2008). https://doi.org/10.1007/s00586-008-0796-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-008-0796-5