Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah.
Pain Med. 2021 Nov 26;22(11):2550-2565. doi: 10.1093/pm/pnab179.
Disruptions caused by the COVID-19 pandemic could disproportionately affect the health of vulnerable populations, including patients experiencing persistent health conditions (i.e., chronic pain), along with populations living within deprived, lower socioeconomic areas. The current cross-sectional study characterized relationships between neighborhood deprivation and perceived changes in pain-related experiences during the COVID-19 pandemic (early-September to mid-October 2020) for adult patients (N = 97) with nonspecific chronic low back pain.
We collected self-report perceived experiences from participants enrolled in an ongoing pragmatic randomized trial across medical centers within the Salt Lake City, Utah and Baltimore, Maryland metropolitans. The Area Deprivation Index (composite of 17 US Census deprivation metrics) reflected neighborhood deprivation based on participants' zip codes.
Although those living in the neighborhoods with greater deprivation endorsed significantly poorer physical (pain severity, pain interference, physical functioning), mental (depression, anxiety), and social health during the pandemic, there were no significant differences for perceived changes in pain-related experiences (pain severity, pain interference, sleep quality) between levels of neighborhood deprivation since the onset of the pandemic. However, those in neighborhoods with greater deprivation endorsed disproportionately worse perceived changes in pain coping, social support, and mood since the pandemic.
The current findings offer evidence that changes in pain coping during the pandemic may be disproportionately worse for those living in deprived areas. Considering poorer pain coping may contribute to long-term consequences, the current findings suggest the need for further attention and intervention to reduce the negative effect of the pandemic for such vulnerable populations.
新冠疫情造成的干扰可能会不成比例地影响弱势群体的健康,包括患有持续性健康问题(如慢性疼痛)的患者,以及生活在贫困、社会经济地位较低地区的人群。本横断面研究描述了在新冠疫情期间(2020 年 9 月初至 10 月中旬),97 名患有非特异性慢性下腰痛的成年患者的邻里剥夺程度与疼痛相关体验变化之间的关系。
我们从正在盐湖城和巴尔的摩的医疗中心进行的一项正在进行的实用随机试验中收集了参与者的自我报告感知体验。居住地区的剥夺程度反映在参与者的邮政编码上。
尽管那些生活在贫困程度较高的社区的人在疫情期间报告了明显较差的身体(疼痛严重程度、疼痛干扰、身体功能)、心理(抑郁、焦虑)和社会健康,但自疫情开始以来,疼痛相关体验的感知变化(疼痛严重程度、疼痛干扰、睡眠质量)在邻里剥夺水平之间没有显著差异。然而,那些生活在贫困程度较高的社区的人报告说,自疫情以来,疼痛应对、社会支持和情绪的感知变化明显更差。
目前的研究结果提供了证据,表明在疫情期间,疼痛应对的变化可能对生活在贫困地区的人更不利。考虑到较差的疼痛应对可能会导致长期后果,目前的研究结果表明,需要进一步关注和干预,以减轻疫情对这些弱势群体的负面影响。