Socioeconomic influences on back problems in the community in Britain.

OBJECTIVE To determine the association between measures of socioeconomic status and reported back pain in a national sample survey of the adult population of Britain. DESIGN Secondary analysis of a cross sectional interview survey (the Health and Lifestyle Survey). SETTING Households in England, Wales, and Scotland. SUBJECTS Those 9003 adults aged 18 years and above who agreed to an interview, from a study base of 12,254 private households that had been identified in a three stage sampling procedure based on electoral registers. Subjects who reported back pain in the month before interview were compared with all those who stated they had not experienced this symptom. MEASURES AND RESULTS Women whose households were in the lowest income category were more likely to report back pain than those in the highest income group (odds ratio 1.6, 95% confidence interval (CI) 1.2, 2.1). In addition, women with no formal educational qualification were more likely to report back pain than women who had a qualification (odds ratio 1.5, 95% CI 1.0, 2.1). These associations were not explained by smoking, obesity, and coexistent depressive symptoms. In men the only socioeconomic link with back pain seemed to be manual occupation. CONCLUSIONS These findings confirm the higher burden of back pain in the socially disadvantaged, but suggest that this cannot yet be explained by known risk factors for back trouble.