Volinn Ernest, Lai Daniel, McKinney Steven, Loeser John D
Department of Neurological Surgery, University of Washington, Seattle, WA 98195 U.S.A. Multidisciplinary Pain Center, University of Washington, Seattle, WA 98195 U.S.A. Department of Biostatistics, University of Washington, Seattle, WA 98195 U.S.A.
Pain. 1988 Apr;33(1):33-39. doi: 10.1016/0304-3959(88)90200-X.
Back pain is a common condition and in most cases is not disabling. We have investigated disabling back pain that leads to health care utilization, time lost from work, and high costs. Disabling back pain remains of obscure origin because the focus in studying it has been too narrow. Our indicator of disability is the industrial insurance claim rate for back sprain by county (N = 39) in the State of Washington. After controlling for the size of the labor force and the proportion of workers in occupations that are particularly at risk of back sprain, we determined the effect of 3 socioeconomic factors on the claim rate: the unemployment rate, percentage receiving food stamps, and per capita income. For 2 of the 3 years studied, socioeconomic factors accounted for about one-third of the variance in the claim rate. Even though claimants of industrial insurance are employed, the unemployment rate was significantly related to the claim rate in the 3 years studied. Our interpretation is that disability is a symptom of distress. Where there is a rise in job insecurity and an attendant rise in economic insecurity, there is a greater likelihood that back pain will become disabling.
背痛是一种常见病症，在大多数情况下并不致残。我们研究了导致医疗保健利用、工作时间损失和高成本的致残性背痛。致残性背痛的病因仍然不明，因为对其研究的重点过于狭窄。我们的残疾指标是华盛顿州各县（N = 39）背部扭伤的工伤保险索赔率。在控制了劳动力规模以及从事特别容易发生背部扭伤职业的工人比例之后，我们确定了3个社会经济因素对索赔率的影响：失业率、领取食品券的百分比和人均收入。在所研究的3年中的2年里，社会经济因素约占索赔率方差的三分之一。尽管工伤保险索赔者有工作，但在所研究的3年中，失业率与索赔率显著相关。我们的解释是，残疾是痛苦的一种症状。在工作不安全感增加以及随之而来的经济不安全感增加的地方，背痛致残的可能性就更大。
