title: Over-indebtedness and its association with the prevalence of back pain.
abstract: BACKGROUND
  Over-indebtedness is an increasing phenomenon worldwide. Massive financial strain, as found in over-indebted persons, might influence the occurrence of back pain. In this explorative study we examined the prevalence of back pain in over-indebted persons in Germany for the first time ever and compared it to the prevalence of back pain in the German general population.
  
  
  METHODS
  A cross sectional study comprising 949 participants (52.6% women) was conducted to collect data on the point prevalence of back pain in an over-indebted collective. A representative sample of the German general population (N = 8318, 53.4% women) was used as non-indebted reference group.
  
  
  RESULTS
  The point prevalence of back pain was 80% in the over-indebted collective, compared to 20% in the general population. The influence of socioeconomic factors on the prevalence of back pain differed partially between the general population and the over-indebted collective. Being over-indebted was identified as an independent effect modifier and was associated with an eleven times increased probability to suffer from back pain (aOR: 10.92, 95%CI: 8.96 - 13.46).
  
  
  CONCLUSIONS
  Until now, only little is known about the effects of intense financial strain like over-indebtedness on health. Our study suggests that over-indebted persons represent a risk group for back pain and that it might be sensible to take financial strain into account when taking a medical history on back pain. Over-indebtedness and private bankruptcy is of increasing importance in industrialized countries, therefore more research on the subject seems to be necessary.
authors: Institute of Occupational and Social Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany. eochsmann@ukaachen.de
authors: Elke B
authors: EB
authors: Ochsmann
authors: Heiko
authors: H
authors: Rueger
authors: Stephan
authors: S
authors: Letzel
authors: Hans
authors: H
authors: Drexler
authors: Eva
authors: E
authors: Muenster
mesh_terms: D000328:Adult; D000368:Aged; D001416:Back Pain / Q000453:epidemiology* / Q000209:etiology; D016361:Bankruptcy; D003430:Cross-Sectional Studies; D057172:Economic Recession; D005260:Female; D005376:Financial Management; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011795:Surveys and Questionnaires