Center for Child Health, Behavior & Development, Seattle Children's Research Institute.
Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA.
Clin J Pain. 2024 Mar 1;40(3):174-181. doi: 10.1097/AJP.0000000000001179.
To determine the associations between neighborhood characteristics and chronic pain during childhood and adolescence in the United States, 2020-2021.
Cross-sectional analysis of the 2020 and 2021 National Survey of Children's Health. National Survey of Children's Health grouped parents' responses to questions about neighborhood characteristics into 5 categories: neighborhood support, neighborhood safety, school support, neighborhood amenities, and the presence of detracting neighborhood elements. Chronic pain was defined as parents reporting their children had "frequent or chronic difficulty with repeated or chronic physical pain, including headache or other back or body pain during the past 12 months." Multivariable Poisson regression analyses estimated associations between neighborhood characteristics and chronic pain, adjusted for sociodemographic characteristics.
The sample contained 55,387 children (6 to 17 years), weighted to represent 44 million nationally. Children had significantly increased rates of chronic pain if they lived in neighborhoods that were unsupportive, unsafe, had unsafe schools, fewer amenities, and greater numbers of detracting elements ( P <0.0001). After adjusting for covariates, children had significantly increased chronic pain if they lived in neighborhoods that were not supportive (adjusted prevalence rate ratio=1.7 (95% CI: 1.5-1.9, P <0.0001), with similar patterns observed for living in neighborhoods characterized as not safe, that did not have safe schools, with fewer amenities, and/or more detracting elements.
Disadvantageous neighborhood characteristics are associated with pediatric chronic pain prevalence. Future research should investigate the underlying mechanisms of this association and guide neighborhood interventions aimed at preventing and decreasing childhood chronic pain and its associated burdens.
在美国，2020-2021 年，确定邻里特征与儿童和青少年慢性疼痛之间的关联。
横断面分析 2020 年和 2021 年全国儿童健康调查。全国儿童健康调查将父母对邻里特征问题的回答分为 5 类：邻里支持、邻里安全、学校支持、邻里便利设施和存在令人讨厌的邻里元素。慢性疼痛定义为父母报告其子女“经常或慢性出现反复或慢性身体疼痛，包括头痛或过去 12 个月内其他背部或身体疼痛”。多变量泊松回归分析估计了邻里特征与慢性疼痛之间的关联，调整了社会人口统计学特征。
样本包含 55387 名儿童（6 至 17 岁），加权后代表全国 4400 万儿童。如果儿童居住在缺乏支持、不安全、学校不安全、便利设施较少且存在较多不良因素的邻里环境中，他们患有慢性疼痛的比率显著增加（P <0.0001）。在调整了协变量后，如果儿童居住在缺乏支持的邻里环境中，他们患有慢性疼痛的比率显著增加（调整后的患病率比=1.7（95%CI：1.5-1.9，P <0.0001），如果居住在不安全、学校不安全、便利设施较少或不良因素较多的邻里环境中，也观察到类似的模式。
不利的邻里特征与儿科慢性疼痛的患病率相关。未来的研究应调查这种关联的潜在机制，并指导旨在预防和减少儿童慢性疼痛及其相关负担的邻里干预措施。
