Background/Purpose:

Low back pain (LBP) affects 67% to 84% of persons residing in industrialized countries.¹ With an estimated 2% of the workforce being compensated for work days lost to back injuries, LBP is responsible for the more lost workdays and disability claims than any other health condition.^2,3 The combined direct and indirect costs have been estimated to be $90 billion annually.³

Of Kentucky’s 29,886 occupational injuries (2010-2011), 28% were low back injuries.⁴ Ninety-two of Kentucky’s 120 counties are designated as medically underserved populations; 71 of these 92 counties are designated as rural areas (2013 USDA Rural/Urban Continuum Codes).⁵ We aim to report the percentage of women who report LBP per Kentucky county, compare rates of LBP in rural versus urban counties, and report predictors of LBP.

Methods:

We extracted data (county of residence, self-reported LBP, and demographics) from the Kentucky Women’s Health Registry, a database with over 16,000 women participants, and used descriptive statistics, two-sample t-tests with unequal variances, and multiple linear regression modeling during data analysis. Data was weight-adjusted based on the percentage of the county population represented in the database.

Results:

Approximately 27.3% (standard deviation (SD)=6%; range=9-46%) (median=27%; mode=27%) of those women residing in an urban county reported LBP; 33.5% of women residing in a rural area reported LBP (SD=9.3%; range=17-64%) (median=33%; mode=35%). Of all Kentucky women, 31.7% (SD=8.9%; range=10-64%) (median=31%; mode=27%) reported having low back pain (Table 1). Using two-sample t-tests, those women who lived in a rural area were significantly more likely to report LBP when compared to those women residing in an urban area (p<.0001). Predictors of LBP using multiple linear regression modeling (residence, disability status, body mass index (BMI), physical activity, and age), were rural residence and BMI. Women residing in a rural county were 5.1% more likely to report LBP compared to urban counties (p=0.0016) and for every 5 unit increase in BMI, there was a 9.1% increase in the likelihood of reported LBP (p=0.0005).

Conclusion:

Study findings suggest that women with increased BMI who reside in a rural area are significantly more likely to report LBP; thus a significant health disparity has identified.