Bingefors Kerstin, Isacson Dag
Pharmacoepidemiology and Pharmacoeconomics, Department of Pharmacy, Uppsala University, BMC, Box 580, Uppsala S-751 23, Sweden.
Eur J Pain. 2004 Oct;8(5):435-50. doi: 10.1016/j.ejpain.2004.01.005.
Headache and musculo-skeletal pain are major public health problems. Substantial proportions of the general population report that they experience pain problems that affect their work, daily living and social life. Epidemiological studies have consistently shown that the prevalence of most pain conditions is higher in women than in men.
Cross-sectional survey in the county of Uppland, Sweden, 1995. Five thousand four hundred and four completed the questionnaire (response rate=68%). In these analyses for persons aged 20-64 years 4506 were included.
Back pain (22.7%) and shoulder pain (21.0%) were the most commonly reported medical problems in the population with pain in arms/legs (15.7%) in fifth and headache (12.5%) in eight place. Major gender differences were found. The prevalence of pain conditions, especially headache, was higher among women. Women reported more severe pain. Co-morbidity between pain conditions and psychiatric and somatic problems was higher among women. Health-related quality of life (SF-36) differed by gender and type of pain condition. The physical dimensions of HRQoL were more affected by headache among men; psychological dimensions were more affected among women. Among both men and women, pain conditions were associated with poorer socioeconomic conditions and life-style factors but there were gender differences. Education and unemployment were important only among men while economical difficulties, half-time work and being married were associated with pain among women. Obesity, early disability retirement, long time sick-leave and lack of exercise were associated with pain conditions generally. Factors associated with pain conditions were unevenly distributed between genders.
There are major differences between men and women in the prevalence and severity of self-reported pain in the population. Biological factors may explain some of the differences but the main explanation is presumably gender disparities in work, economy, daily living, social life and expectations between women and men. Although improved working conditions are of importance, deeper societal changes are needed to reduce the inequities in pain experiences between women and men.
头痛和肌肉骨骼疼痛是主要的公共卫生问题。相当一部分普通人群报告称，他们经历的疼痛问题影响了他们的工作、日常生活和社交生活。流行病学研究一直表明，大多数疼痛状况在女性中的患病率高于男性。
1995年在瑞典乌普萨拉县进行的横断面调查。5404人完成了问卷调查（回复率=68%）。在这些针对20至64岁人群的分析中，纳入了4506人。
背痛（22.7%）和肩痛（21.0%）是该人群中最常报告的医疗问题，手臂/腿部疼痛（15.7%）排在第五位，头痛（12.5%）排在第八位。发现了主要的性别差异。疼痛状况的患病率，尤其是头痛，在女性中更高。女性报告的疼痛更严重。疼痛状况与精神和躯体问题之间的共病在女性中更高。与健康相关的生活质量（SF-36）因性别和疼痛状况类型而异。男性中，HRQoL的身体维度受头痛影响更大；女性中，心理维度受影响更大。在男性和女性中，疼痛状况都与较差的社会经济状况和生活方式因素相关，但存在性别差异。教育和失业仅在男性中重要，而经济困难、兼职工作和已婚与女性的疼痛相关。肥胖、提前病退、长期病假和缺乏运动通常与疼痛状况相关。与疼痛状况相关的因素在性别之间分布不均。
在人群中，自我报告的疼痛患病率和严重程度在男性和女性之间存在重大差异。生物学因素可能解释了部分差异，但主要原因可能是男女在工作、经济、日常生活、社交生活和期望方面的性别差异。虽然改善工作条件很重要，但需要更深入的社会变革来减少男女在疼痛经历方面的不平等。
