Does income matter for troublesome neck pain? A population-based study on risk and prognosis
- Lina Palmlöf1,
- Eva Skillgate1,2,
- Lars Alfredsson1,
- Eva Vingård3,
- Cecilia Magnusson4,
- Michael Lundberg4,
- Lena W Holm1
- 1Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- 2Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
- 3Occupational and Environmental Medicine, Department of Medical Science, Uppsala University, Uppsala, Sweden
- 4Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Correspondence to Lina Palmlöf, Institute of Environmental medicine, Karolinska Institutet, Box 20, Solna 177 71, Sweden;
Contributors All authors contributed to the design of the study and interpreted data. ML and LP made the statistical analyses. LP wrote the first version of the manuscript. All authors critically revised different versions of the manuscript. All authors read the final version of the manuscript.
- Accepted 28 January 2012
- Published Online First 12 March 2012
Background Studies have shown associations between higher income and better health, but income has not been studied in relation to neck pain. The aims of this cohort study were to assess the sex-specific role of disposable income for onset and prognosis of neck pain in the general population and if economic stress influences such potential associations.
Methods Two subcohorts were identified in the Stockholm Public Health Cohort with data from 2002. Cohort I (risk cohort) included persons without neck pain (n=8348). Cohort II (prognostic cohort) included persons with occasional neck pain during the previous 6 months (n=10 523). Both cohorts were assessed for long duration troublesome neck pain (LDNP) in 2007. Individual income was defined as aggregated annual family income in 2002 with each family member assigned a weighted consumption share, based on salary, pensions and social benefits. LDNP in 2007 was defined as having had troublesome neck pain lasting for three or more consecutive months the previous 5 years. Association between income and LDNP, considering potential confounding, was investigated by multivariable logistic regression. Economic stress was tested as effect modifier between income and LDNP.
Results In both cohorts, associations were found between lower income and a higher risk for LDNP. The results were similar between the sexes. Economic stress modified the associations in both cohorts.
Conclusions Low income may be a risk as well as prognostic factor for developing LDNP. Furthermore, the results indicate that economic stress may be an underlying factor to consider when studying associations between income and neck pain.
- Neck pain
- cohort studies
- longitudinal studies
- child health
- health expectancy
Funding The Stockholm Public Health Cohort was financed by Stockholm County Council. The study was supported by grants from the Swedish Council for Working Life and Social Research. The salary for LP was provided by the Doctoral School in Health Care Sciences at Karolinska Institutet, Stockholm, Sweden.
Competing interests None.
Ethics approval Ethics approval was provided by Regional Committee on Ethics at Karolinska Institutet.
Provenance and peer review Not commissioned; externally peer reviewed.