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The Contextual Effect of Area-Level Unemployment Rate on Lower Back Pain: A Multilevel Analysis of Three Consecutive Surveys of 962,586 Workers in Japan

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  • Takaaki Ikeda

    (Department of Health Policy Science, Graduate School of Medical Science, Yamagata University, Yamagata 990-9585, Japan
    Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan)

  • Kemmyo Sugiyama

    (Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan)

  • Jun Aida

    (Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan)

  • Toru Tsuboya

    (Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan)

  • Ken Osaka

    (Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan)

Abstract

This study examined the associations between area-level unemployment rates and lower back pain using large-scale data provided by the Japanese working population. We analyzed data from a nationally representative, repeated, cross-sectional study across three waves from 2010, 2013, and 2016 in 47 Japanese subnational level areas. Workers aged 18–64 years ( n = 962,586) were eligible to participate in the study. A multilevel logistic model was used to examine the association between the unemployment rate and lower back pain. The self-report of lower back pain was a dependent variable. The prefecture-level unemployment rate was analyzed as an independent variable, adjusted for individual-level covariates (e.g., gender, age, socioeconomic status). After adjusting for all covariates, the main effect of the prefecture-level unemployment rate was statistically significant: the odds ratio (OR) (95% credible interval (CrI)) was 1.01 (1.002, 1.03). Additionally, the OR (95% CrI) for the interaction between gender and the prefecture-level unemployment rate was 1.02 (1.01, 1.03) indicating that women were more affected by area-level employment status than men. In conclusion, a significant association between the unemployment rate and lower back pain was observed in the Japanese working population. Women were more sensitive to the unemployment rate.

Suggested Citation

  • Takaaki Ikeda & Kemmyo Sugiyama & Jun Aida & Toru Tsuboya & Ken Osaka, 2019. "The Contextual Effect of Area-Level Unemployment Rate on Lower Back Pain: A Multilevel Analysis of Three Consecutive Surveys of 962,586 Workers in Japan," IJERPH, MDPI, vol. 16(20), pages 1-11, October.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:20:p:4016-:d:278474
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    2. Liying Song & Yan Wang & Baodong Chen & Tan Yang & Weiliang Zhang & Yafeng Wang, 2020. "The Association between Health Insurance and All-Cause, Cardiovascular Disease, Cancer and Cause-Specific Mortality: A Prospective Cohort Study," IJERPH, MDPI, vol. 17(5), pages 1-11, February.

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