title: Perceived gender inequality in the couple relationship and musculoskeletal pain in middle-aged women and men.
abstract: OBJECTIVE
  Musculoskeletal pain is a major health problem, especially in women, and is partially determined by psychosocial factors. The aim of the present study was to investigate whether gender inequality in the couple relationship was related to musculoskeletal pain.
  
  
  METHODS
  Participants (n=721; 364 women and 357 men) were all individuals living in a couple relationship in the Northern Swedish Cohort, a 26-year Swedish cohort study. Self-administered questionnaire data at age 42 years comprised perceived gender inequality in the couple relationship and musculoskeletal pain (in three locations, summarised into one score and median-split), concurrent demographic factors, psychological distress, and previous musculoskeletal pain at age 30 years. Associations were examined using logistic regression.
  
  
  RESULTS
  Gender inequality was positively associated with symptoms of musculoskeletal pain in the total sample, remaining significant after addition of possible confounders and of previous musculoskeletal pain. Separate adjustment for concurrent psychological distress attenuated the association but not below significance. The association was present and of comparable strength in both women and men.
  
  
  CONCLUSIONS
  Gender inequality in the couple relationship might contribute to the experience of musculoskeletal pain in both women and men. The results highlight the potential adverse bodily consequences of living in unequal relationships.
authors.affiliation: 1Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Bohlin
authors.forename: Christina
authors.initials: C
authors.lastname: Ahlgren
authors.forename: Anne
authors.initials: A
authors.lastname: Hammarstrom
authors.forename: Per E
authors.initials: PE
authors.lastname: Gustafsson
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D059352:Musculoskeletal Pain / Q000523:psychology*; D011446:Prospective Studies; D012737:Sex Factors; D012938:Social Perception; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Cohort study; gender equality; musculoskeletal pain; social determinants of health