title: Racial differences in the incidence of acute low back pain in United States military service members.
abstract: METHODS
  An epidemiological study.
  
  
  OBJECTIVE
  To determine the effect of race on the incidence of acute low back pain, resulting in a health care encounter in active duty military service members.
  
  
  BACKGROUND
  Although racial differences in the incidence of low back pain have been documented in previous studies, currently no consensus exists on the relative risk between these groups.
  
  
  METHODS
  A query was performed using the Armed Forces Health Surveillance Center database for the International Classification of Diseases, Ninth Revision code for low back pain (724.20). A total of 12,399,276 person-years of data were analyzed and stratified by age, race, and sex. Incidence rates were calculated and compared using the multivariate Poisson regression analysis.
  
  
  RESULTS
  A total of 467,950 cases of low back pain resulted in a visit to a health care provider in our population, with an overall incidence rate of 37.74 per 1000 person-years. Asians/Pacific Islanders had the lowest incidence rate of 30.7 and blacks had the highest with 43.7. Female sex and older age were also significant risk factors but with significantly different effect sizes between racial groups. Native Americans/Alaskan Natives demonstrated the greatest effect of age on low back pain incidence rates, with a 126% increase between the youngest and oldest age groups compared with a 36% difference in whites.
  
  
  CONCLUSIONS
  Race, sex, and age were all found to be significant risk factors for acute low back pain. The highest rates were identified in blacks followed by whites, Hispanics, and American Indian/Alaskan Native, and the lowest rates were identified in Asians/Pacific Islanders. Significant differences in the effect of sex and age were identified between the different racial groups.
authors.affiliation: Department of Surgery, Orthopaedic Surgery Service, Tripler Army Medical Center, Honolulu, HI 96859, USA. jeffrey.bruce.knox@us.army.mil
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Knox
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Orchowski
authors.forename: Brett
authors.initials: B
authors.lastname: Owens
mesh_terms: D000208:Acute Disease; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data; D017116:Low Back Pain / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data; D044469:Racial Groups / Q000706:statistics & numerical data*; D012306:Risk; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult