School of Social Work, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States.
PLoS One. 2022 Jun 3;17(6):e0269627. doi: 10.1371/journal.pone.0269627. eCollection 2022.
Chronic back pain is prevalent in Brazil, leading to enormous healthcare costs and social burdens. It also disproportionately affects low-income and less-healthy people.
This study examines the associations of chronic back pain with biological, psychological, and social factors; how it limits usual activities; and how chronic back pain influences the use of treatment services.
Using Brazil's National Health Survey (PNS-2019), multivariate logistic regressions were conducted to examine how biological, psychological, and social factors correlate with chronic back pain, limitations on usual activities, and pain treatment.
PNS-2019 data showed that 23.4% (95% CI 22.8-24.0) of Brazilian adults aged over 20 reported back pain. A higher prevalence of chronic back pain was associated with biological factors (older age, being female, overweight or obese, current smoking, and having more chronic conditions), lower social conditions (low education, low per capita household income, non-married, and living in rural areas), and poor psychological health (more depressive symptoms). Chronic back pain is more likely to limit usual activities among those with low social conditions (lower education, lower income), poor physical and behavioral health (obese, current smokers, and those with a greater number of chronic conditions), and worse psychological health (more depressive symptoms). However, married people and those who do not consume alcohol were also more likely to report limited activities. Among those with back pain, 68% received at least one form of treatment. Those with intense limitations on their usual activities were 2.2 times as likely to report treatment. People with higher social conditions (higher income, college education, and private health insurance) were more likely to receive treatment.
The results show significant biological, psychological, and social disparities in the prevalence of chronic back pain in Brazil. The findings point to the need for tailored policies and prevention programs with attention to vulnerable groups. Even though Brazil has universal health care, those with better socioeconomic conditions are more likely to receive treatment.
慢性背痛在巴西普遍存在，导致巨大的医疗保健成本和社会负担。它也不成比例地影响低收入和健康状况较差的人群。
本研究探讨了慢性背痛与生物、心理和社会因素的关联；它如何限制日常活动；以及慢性背痛如何影响治疗服务的使用。
使用巴西国家卫生调查（PNS-2019），进行多变量逻辑回归分析，以研究生物、心理和社会因素与慢性背痛、日常活动受限以及疼痛治疗的相关性。
PNS-2019 数据显示，20 岁以上的巴西成年人中有 23.4%（95%CI 22.8-24.0）报告有背痛。慢性背痛的更高患病率与生物因素（年龄较大、女性、超重或肥胖、当前吸烟以及患有更多慢性疾病）、较低的社会条件（低教育程度、低人均家庭收入、未婚和居住在农村地区）以及较差的心理健康（更多抑郁症状）有关。慢性背痛更有可能限制社会条件较差的人群（较低的教育程度、较低的收入）、身体和行为健康较差的人群（肥胖、当前吸烟者以及患有更多慢性疾病的人群）以及心理健康较差的人群（更多抑郁症状）的日常活动。然而，已婚人士和不饮酒的人士也更有可能报告活动受限。在有背痛的人群中，有 68%接受了至少一种治疗形式。那些日常活动受限严重的人报告治疗的可能性是其两倍。社会条件较好的人群（较高的收入、大学教育和私人医疗保险）更有可能接受治疗。
研究结果表明，巴西慢性背痛的患病率存在显著的生物、心理和社会差异。这些发现表明，需要制定有针对性的政策和预防计划，关注弱势群体。尽管巴西拥有全民医疗保健，但社会经济条件较好的人群更有可能接受治疗。
