title: [Back pain and social status among the working population: what is the association? Results from a German general population survey].
abstract: BACKGROUND
  Little empirical evidence is available on differential associations between social status indicators and back pain in Germany. This study therefore systematically evaluated associations between different indicators of social status and back pain.
  
  
  METHODS
  In total 4,412 employed adults, aged 18 to 65 years participated in a postal survey in 5 regions of Germany. The point prevalence and 1-year prevalence of back pain were assessed as well as the level of disabling back pain. Educational level, professional category and household income served as measures of social status. Associations between social status and back pain have been assessed cross-sectionally using Poisson regression.
  
  
  RESULTS
  Educational level was the best predictor for back pain among the assessed social status indicators. Adults with a low educational level had almost a 4-fold risk of reporting disabling back pain compared to subjects with a high educational level. Associations were highest for disabling back pain and attenuated strongly over the point prevalence towards the 1-year prevalence.
  
  
  CONCLUSIONS
  Back pain cannot generally be regarded as a symptom of a low social status. However, social inequality is of major importance regarding the prediction of severe back problems. A better understanding of mediating factors is essential for the prevention and therapy.
authors: Institut für Community Medicine, Universität Greifswald, Walther Rathenau Str 48, 17487 Greifswald, Deutschland. carsten.schmidt@uni-greifswald.de
authors: C O
authors: CO
authors: Schmidt
authors: J
authors: J
authors: Moock
authors: R A
authors: RA
authors: Fahland
authors: Y Y-S
authors: YY
authors: Feng
authors: T
authors: T
authors: Kohlmann
references: Pain. 1992 Aug;50(2):133-149
references: 1408309
references: J Epidemiol Community Health. 1994 Apr;48(2):166-70
references: 8189172
references: Spine (Phila Pa 1976). 2004 Jul 15;29(14):1561-6
references: 15247579
references: Ann Rheum Dis. 1992 Jul;51(7):835-43
references: 1385940
references: J Health Soc Behav. 1996 Mar;37(1):104-20
references: 8820314
references: Int Arch Occup Environ Health. 2005 May;78(4):253-69
references: 15824916
references: Eur J Epidemiol. 1998 Jan;14(1):79-87
references: 9517877
references: J Epidemiol Community Health. 2001 Jul;55(7):455-68
references: 11413174
references: Gesundheitswesen. 2008 May;70(5):281-8
references: 18604766
references: Spine (Phila Pa 1976). 2007 Aug 15;32(18):2005-11
references: 17700449
references: J Natl Med Assoc. 2007 Oct;99(10):1160-9
references: 17987920
references: Occup Environ Med. 2001 Nov;58(11):728-34
references: 11600729
references: Am J Public Health. 1984 Jun;74(6):574-9
references: 6232862
references: Spine (Phila Pa 1976). 2004 Jan 1;29(1):70-7; discussion 77-8
references: 14699279
references: J Epidemiol Community Health. 2006 Sep;60(9):804-10
references: 16905727
references: Spine (Phila Pa 1976). 2004 Jun 15;29(12):1355-60; discussion 1361
references: 15187638
references: J Chronic Dis. 1987;40(9):865-74
references: 3597688
references: Spine (Phila Pa 1976). 2002 Mar 1;27(5):E109-20
references: 11880847
references: Gesundheitswesen. 2008 Mar;70(3):145-53
references: 18415922
references: Int J Public Health. 2008;53(3):165-7
references: 19127890
references: Spine (Phila Pa 1976). 2000 Jun 1;25(11):1390-7
references: 10828921
references: Eur Spine J. 2008 Dec;17(12):1727-34
references: 18830719
references: N Engl J Med. 2008 Jun 5;358(23):2468-81
references: 18525043
references: Int J Equity Health. 2004 May 6;3(1):3
references: 15128460
references: J Chronic Dis. 1985;38(8):691-702
references: 3160720
references: Int J Public Health. 2008;53(2):118-9
references: 18681341
references: Gesundheitswesen. 2005 Oct;67(10):685-93
references: 16235136
references: Br J Ind Med. 1987 May;44(5):327-36
references: 2954580
references: Spine (Phila Pa 1976). 2006 Feb 15;31(4):479-84
references: 16481962
references: Community Dent Oral Epidemiol. 2010 Apr;38(2):120-8
references: 20074293
references: Am J Ind Med. 2005 Dec;48(6):459-69
references: 16299708
references: Occup Environ Med. 2006 Apr;63(4):278-82
references: 16556749
references: Soc Sci Med. 2009 Aug;69(4):489-99
references: 19523728
references: Pain. 2010 Apr;149(1):50-56
references: 20185238
references: J Am Geriatr Soc. 2009 Oct;57(10):1844-9
references: 19682128
references: Am J Epidemiol. 1998 Oct 1;148(7):671-82
references: 9778174
references: Arthritis Rheum. 1987 Nov;30(11):1247-53
references: 2961343
references: Ann Rheum Dis. 2009 Oct;68(10):1591-5
references: 18952642
references: Lancet. 1997 Jun 7;349(9066):1655-9
references: 9186383