TY - JOUR
T1 - The Influence of Race, Sex, and Social Disadvantage on Self-reported Health in Patients Presenting with Chronic Musculoskeletal Pain
AU - Cheng, Abby L.
AU - Bradley, Ethan C.
AU - Brady, Brian K.
AU - Calfee, Ryan P.
AU - Klesges, Lisa M.
AU - Colditz, Graham A.
AU - Prather, Heidi
N1 - Funding Information:
Supported by the Doris Duke Charitable Foundation and by grant K23AR074520 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (A.L.C.). Neither funding body had any role in the study design; collection, analysis, or interpretation of the data; writing of the report; or decision to submit the report for publication.
Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Objective The aim of the study was to better address sociodemographic-related health disparities. This study examined which sociodemographic variables most strongly correlate with self-reported health in patients with chronic musculoskeletal pain. Design This single-center, cross-sectional study examined adult patients, followed by a physiatrist for chronic (≥4 yrs) musculoskeletal pain. Sociodemographic variables considered were race, sex, and disparate social disadvantage (measured as residential address in the worst vs. best Area Deprivation Index national quartile). The primary comparison was the adjusted effect size of each variable on physical and behavioral health (measured by Patient-Reported Outcomes Measurement Information System [PROMIS]). Results In 1193 patients (age = 56.3 ± 13.0 yrs), disparate social disadvantage was associated with worse health in all domains assessed (PROMIS Physical Function Β = -2.4 points [95% confidence interval = -3.8 to -1.0], Pain Interference = 3.3 [2.0 to 4.6], Anxiety = 4.0 [1.8 to 6.2], and Depression = 3.7 [1.7 to 5.6]). Black race was associated with greater anxiety than white race (3.2 [1.1 to 5.3]), and female sex was associated with worse physical function than male sex (-2.5 [-3.5 to -1.5]). Conclusions Compared with race and sex, social disadvantage is more consistently associated with worse physical and behavioral health in patients with chronic musculoskeletal pain. Investment to ameliorate disadvantage in geographically defined communities may improve health in sociodemographically at-risk populations.
AB - Objective The aim of the study was to better address sociodemographic-related health disparities. This study examined which sociodemographic variables most strongly correlate with self-reported health in patients with chronic musculoskeletal pain. Design This single-center, cross-sectional study examined adult patients, followed by a physiatrist for chronic (≥4 yrs) musculoskeletal pain. Sociodemographic variables considered were race, sex, and disparate social disadvantage (measured as residential address in the worst vs. best Area Deprivation Index national quartile). The primary comparison was the adjusted effect size of each variable on physical and behavioral health (measured by Patient-Reported Outcomes Measurement Information System [PROMIS]). Results In 1193 patients (age = 56.3 ± 13.0 yrs), disparate social disadvantage was associated with worse health in all domains assessed (PROMIS Physical Function Β = -2.4 points [95% confidence interval = -3.8 to -1.0], Pain Interference = 3.3 [2.0 to 4.6], Anxiety = 4.0 [1.8 to 6.2], and Depression = 3.7 [1.7 to 5.6]). Black race was associated with greater anxiety than white race (3.2 [1.1 to 5.3]), and female sex was associated with worse physical function than male sex (-2.5 [-3.5 to -1.5]). Conclusions Compared with race and sex, social disadvantage is more consistently associated with worse physical and behavioral health in patients with chronic musculoskeletal pain. Investment to ameliorate disadvantage in geographically defined communities may improve health in sociodemographically at-risk populations.
KW - Chronic Pain
KW - Health Status Disparities
KW - Musculoskeletal Diseases
KW - Socioeconomic Factors
UR - http://www.scopus.com/inward/record.url?scp=85124850735&partnerID=8YFLogxK
U2 - 10.1097/PHM.0000000000001774
DO - 10.1097/PHM.0000000000001774
M3 - Article
C2 - 33935150
AN - SCOPUS:85124850735
SN - 0894-9115
VL - 101
SP - 211
EP - 216
JO - American Journal of Physical Medicine and Rehabilitation
JF - American Journal of Physical Medicine and Rehabilitation
IS - 3
ER -