Socioeconomic variation in back and joint pain in Finland

Differences in the prevalence of back and joint pain by occupational class and education were studied in surveys representative of adult Finns. The effects of lifestyle factors and mental distress on these differences were also analysed. The material comprised 3915 women and 3629 men, all occupationally active. Occupational class and level of education were associated with back and joint pain; the associations were more obvious in men than in women. Among men, the age-adjusted odds ratio of joint pain in farmers was 3.2 (95% CI: 2.1-5.0), in manual workers 2.6 (1.9-3.6), in entrepreneurs 2.4 (1.5-3.7) and in lower white-collar workers 1.7 (1.1-2.4) as compared with upper white-collar employees. Similar odds ratios of back pain were 2.1 (1.6-2.9) in farmers, 1.8 (1.5-2.3) in manual workers, 1.7 (1.2-2.4) in entrepreneurs and 1.4 (1.1-1.7) in lower white-collar workers. Most of the associations persisted in multivariate analyses, in which height, marital status, lifestyle (smoking, leisure-time physical activity and body mass index (BMI)) and mental distress were considered; in these models, mental distress was consistently associated with pain. Back pain was associated with smoking in men and with BMI in women; BMI was also associated with joint pain in both sexes. In women, height showed an association with back pain for which a doctor had been consulted. Marital status, alcohol consumption, leisure-time physical activity and the urbanization level of the community were not important as determinants of pain.

Obvious differences occurred in back and joint pain by indicators of social class that were not due to socioeconomic differences in lifestyle, height or mental distress.