title: Low socioeconomic status is associated with chronic musculoskeletal complaints among 46,901 adults in Norway.
abstract: OBJECTIVE
  A study was undertaken to evaluate the relationship between socioeconomic status (SES) and chronic musculoskeletal complaints (MSC), and to determine how this relationship is influenced by change in SES.
  
  
  METHODS
  Two consecutive public health surveys within the county of Nord-Trøndelag, Norway, were conducted in 1984-86 (HUNT-1) and 1995-97 (HUNT-2). Among 46,901 adults who participated in both surveys, 24,127 persons (51%) in HUNT-2 who reported MSC continuously for at least 3 months during the past year were defined as having chronic MSC. Prevalence of chronic MSC was estimated at nine anatomical sites using multiple logistic regression with odds ratio (OR) and 95% confidence interval (CI) as measures of association with SES.
  
  
  RESULTS
  When defining SES by educational level, type of occupation, or income, low status was associated with increased prevalence of chronic MSC (age-adjusted analyses). The negative influence of low education or low occupation level was not eliminated by increasing the level of education or occupation from HUNT-1 to HUNT-2, in contrast with what was found for individuals with higher income level in HUNT-2 than in HUNT-1. The relationship with SES was more evident among individuals with musculoskeletal symptoms 15 days during the past month than among those with less than 15 days, evident at all nine different anatomical sites. The strongest relationship was found between low SES and prevalence of widespread chronic MSC.
  
  
  CONCLUSIONS
  Individuals with low SES had higher prevalence of chronic MSC than those with high SES. Future studies should try to clarify whether chronic MSC are a cause or consequence of low SES.
authors.affiliation: Department of Clinical Neuroscience, Section of Neurology, Norwegian University of Science and Technology, Trondheim, Norway. knut.hagen@medisin.ntnu.no
authors.forename: Knut
authors.initials: K
authors.lastname: Hagen
authors.forename: John-Anker
authors.initials: JA
authors.lastname: Zwart
authors.forename: Sven
authors.initials: S
authors.lastname: Svebak
authors.forename: Gunnar
authors.initials: G
authors.lastname: Bovim
authors.forename: Lars
authors.initials: L
authors.lastname: Jacob Stovner
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000209:etiology; D009664:Norway / Q000453:epidemiology; D009790:Occupations; D015995:Prevalence; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires