Association of Individual and Contextual Factors with Chronic Spine Problems: An Analysis from the National Health Survey

Aryostennes Miquéias da Silva Ferreira, Sanderson José Costa de Assis (), Clécio Gabriel de Souza, Geronimo José Bouzas Sanchis, Rebeca Freitas de Oliveira Nunes, Marcello Barbosa Otoni Gonçalves Guedes, Johnnatas Mikael Lopes and Angelo Giuseppe Roncalli
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Aryostennes Miquéias da Silva Ferreira: Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz 59200-000, RN, Brazil
Sanderson José Costa de Assis: Department of Dentistry, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil
Clécio Gabriel de Souza: Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz 59200-000, RN, Brazil
Geronimo José Bouzas Sanchis: Department of Dentistry, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil
Rebeca Freitas de Oliveira Nunes: Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz 59200-000, RN, Brazil
Marcello Barbosa Otoni Gonçalves Guedes: Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil
Johnnatas Mikael Lopes: Department of Medicine, Federal University of Vale do São Francisco, Paulo Afonso 56304-917, BA, Brazil
Angelo Giuseppe Roncalli: Department of Dentistry, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil

IJERPH, 2025, vol. 22, issue 6, 1-11

Abstract: The spine is the most affected region, which compromises functionality and generates absenteeism, increased health care costs, and disability retirement rates. Based on the biopsychosocial model, it is believed that chronic back problems are the result of a complex network of factors, both individual and contextual. A cross-sectional study was developed with data from the 2013 National Health Survey, the United Nations Development Programme, and the National Register of Health Establishments (state level) for the second and third levels of aggregation, respectively. Multilevel Poisson regression was performed at three levels. The prevalence of chronic back problems was 18.5% (95% CI 17.8; 19.1), with a higher prevalence in females (RP = 1.23; 95% CI 1.15; 1.30), those aged above 49 years (RP = 1.75; 95% CI 1.61; 1.90), those performing heavy activities at work (RP = 1.37; 95% CI 1.28; 1.46), those with depressive days (RP = 1.70; 95% CI 1.50; 1.94), those who were smokers (RP = 1.37; 95% CI 1.27; 1.48), and those in states with a higher coefficient of Family Health Support Team per 100,000 inhabitants (PR = 1.28; 95% CI 1.07; 1.54). Chronic spine problems were associated with biological and behavioral factors and were more strongly associated with the coefficient of Family Health Support Team in Brazilian municipalities.

Keywords: spinal diseases; social determinants of health; multilevel analysis; health surveys cross-sectional studies (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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