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208 ARE OCCUPATIONAL FACTORS IMPORTANT DETERMINANTS FOR SOCIO-ECONOMIC INEQUALITIES IN MUSCULOSKELETAL PAIN?
Socio-economic inequalities in health are well documented, and the impact of different determinants needs to be explored. The aim of this study was to quantify socio-economic inequalities in low back pain, neck/shoulder pain and arm pain in the general working population, and to examine the impact of job characteristics on these inequalities.
All economically active 30-, 40-, and 45-year-old subjects who attended the Oslo Health Study 2000–2001 and answered questions on physical job demands and job autonomy and musculoskeletal pain were included (n = 7293). Occupational class was used as a measure of socio-economic position. The lower occupational classes were compared to higher grade professionals, and prevalence, prevalence ratios (PR), prevalence differences (PD) and population attributable fractions (PAF) were calculated.
There were marked socio-economic gradients in musculoskeletal pain, steeper in men than in women. The relative differences (PR) were larger for low back pain and arm pain than for neck/shoulder pain. The absolute differences (PD) were largest for low back pain. For non-skilled workers compared to higher grade professionals, the PD was 25 percent points (pp) in males and 15 pp in females. For neck/shoulder pain and arm pain, the corresponding differences were approximately 15 pp in men and 10 pp in women. Physical job demands explained a substantial proportion of absolute occupational class inequalities in low back pain (22% in male and 49% in female non-skilled workers), while job autonomy was more important in explaining inequalities in neck/shoulder pain (34% and 25%, respectively) and arm pain (15% and 19%). PAF estimates supported the impact of the job characteristics at the population level.
Physical job demands and job autonomy explained a substantial proportion of occupational class inequalities in musculoskeletal pain in the working population. This suggests the workplace might be an important arena for prevention and thereby reduction of socio-economic inequalities in …