Formal education and back-related disability

In search of an explanation

C. Dionne, T. D. Koepsell, M. Von Korff, Richard (Rick) Deyo, W. E. Barlow, H. Checkoway

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Study Design. The present study is a 2-year prospective study with repeated measurements. Objectives. To examine the association of education with back-related disability along with four sets of variables that might explain this relationship: clinical, behavioral, and environmental factors; occupational variables; health care use; and interactions between stressful events and coping strategies. Summary of Background Data. Although education has been found to be associated with back-related disability in previous reports, this relationship remains to be explained. Examination of this association may yield a better understanding of the causes and natural history of disability resulting from back pain. Methods. Subjects were 1213 enrollees of a Health Maintenance Organization (HMO) who consulted a primary care physician for back pain in 1989-1990, completed a baseline telephone interview, and had a follow-up evaluation after 1 and 2 years, using a modified version of the Roland-Morris Scale to measure disability. Results. Subjects who completed 13 years or more of schooling had less disability and a greater decline in their disability over time than those who completed less schooling. Occupational characteristics and somatization were among the strongest explanatory factors. Cigarette smoking contributed to the explanation of the cross-sectional association. Conclusions. Education is associated cross-sectionally and longitudinally with disability resulting from back pain. A wide range of variables may mediate the education-back- related disability association, including a propensity to report diffuse physical symptoms (somatization), lifestyle (e.g., cigarette smoking), and occupational factors.

Original languageEnglish (US)
Pages (from-to)2721-2730
Number of pages10
JournalSpine
Volume20
Issue number24
StatePublished - 1995
Externally publishedYes

Fingerprint

Back Pain
Education
Smoking
Health Maintenance Organizations
Primary Care Physicians
Natural History
Life Style
Prospective Studies
Interviews
Delivery of Health Care

Keywords

  • back pain
  • disability
  • educational status

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Dionne, C., Koepsell, T. D., Von Korff, M., Deyo, R. R., Barlow, W. E., & Checkoway, H. (1995). Formal education and back-related disability: In search of an explanation. Spine, 20(24), 2721-2730.

Formal education and back-related disability : In search of an explanation. / Dionne, C.; Koepsell, T. D.; Von Korff, M.; Deyo, Richard (Rick); Barlow, W. E.; Checkoway, H.

In: Spine, Vol. 20, No. 24, 1995, p. 2721-2730.

Research output: Contribution to journalArticle

Dionne, C, Koepsell, TD, Von Korff, M, Deyo, RR, Barlow, WE & Checkoway, H 1995, 'Formal education and back-related disability: In search of an explanation', Spine, vol. 20, no. 24, pp. 2721-2730.
Dionne C, Koepsell TD, Von Korff M, Deyo RR, Barlow WE, Checkoway H. Formal education and back-related disability: In search of an explanation. Spine. 1995;20(24):2721-2730.
Dionne, C. ; Koepsell, T. D. ; Von Korff, M. ; Deyo, Richard (Rick) ; Barlow, W. E. ; Checkoway, H. / Formal education and back-related disability : In search of an explanation. In: Spine. 1995 ; Vol. 20, No. 24. pp. 2721-2730.
@article{2cc86251daf74e5a9a9ddb527feb471f,
title = "Formal education and back-related disability: In search of an explanation",
abstract = "Study Design. The present study is a 2-year prospective study with repeated measurements. Objectives. To examine the association of education with back-related disability along with four sets of variables that might explain this relationship: clinical, behavioral, and environmental factors; occupational variables; health care use; and interactions between stressful events and coping strategies. Summary of Background Data. Although education has been found to be associated with back-related disability in previous reports, this relationship remains to be explained. Examination of this association may yield a better understanding of the causes and natural history of disability resulting from back pain. Methods. Subjects were 1213 enrollees of a Health Maintenance Organization (HMO) who consulted a primary care physician for back pain in 1989-1990, completed a baseline telephone interview, and had a follow-up evaluation after 1 and 2 years, using a modified version of the Roland-Morris Scale to measure disability. Results. Subjects who completed 13 years or more of schooling had less disability and a greater decline in their disability over time than those who completed less schooling. Occupational characteristics and somatization were among the strongest explanatory factors. Cigarette smoking contributed to the explanation of the cross-sectional association. Conclusions. Education is associated cross-sectionally and longitudinally with disability resulting from back pain. A wide range of variables may mediate the education-back- related disability association, including a propensity to report diffuse physical symptoms (somatization), lifestyle (e.g., cigarette smoking), and occupational factors.",
keywords = "back pain, disability, educational status",
author = "C. Dionne and Koepsell, {T. D.} and {Von Korff}, M. and Deyo, {Richard (Rick)} and Barlow, {W. E.} and H. Checkoway",
year = "1995",
language = "English (US)",
volume = "20",
pages = "2721--2730",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "24",

}

TY - JOUR

T1 - Formal education and back-related disability

T2 - In search of an explanation

AU - Dionne, C.

AU - Koepsell, T. D.

AU - Von Korff, M.

AU - Deyo, Richard (Rick)

AU - Barlow, W. E.

AU - Checkoway, H.

PY - 1995

Y1 - 1995

N2 - Study Design. The present study is a 2-year prospective study with repeated measurements. Objectives. To examine the association of education with back-related disability along with four sets of variables that might explain this relationship: clinical, behavioral, and environmental factors; occupational variables; health care use; and interactions between stressful events and coping strategies. Summary of Background Data. Although education has been found to be associated with back-related disability in previous reports, this relationship remains to be explained. Examination of this association may yield a better understanding of the causes and natural history of disability resulting from back pain. Methods. Subjects were 1213 enrollees of a Health Maintenance Organization (HMO) who consulted a primary care physician for back pain in 1989-1990, completed a baseline telephone interview, and had a follow-up evaluation after 1 and 2 years, using a modified version of the Roland-Morris Scale to measure disability. Results. Subjects who completed 13 years or more of schooling had less disability and a greater decline in their disability over time than those who completed less schooling. Occupational characteristics and somatization were among the strongest explanatory factors. Cigarette smoking contributed to the explanation of the cross-sectional association. Conclusions. Education is associated cross-sectionally and longitudinally with disability resulting from back pain. A wide range of variables may mediate the education-back- related disability association, including a propensity to report diffuse physical symptoms (somatization), lifestyle (e.g., cigarette smoking), and occupational factors.

AB - Study Design. The present study is a 2-year prospective study with repeated measurements. Objectives. To examine the association of education with back-related disability along with four sets of variables that might explain this relationship: clinical, behavioral, and environmental factors; occupational variables; health care use; and interactions between stressful events and coping strategies. Summary of Background Data. Although education has been found to be associated with back-related disability in previous reports, this relationship remains to be explained. Examination of this association may yield a better understanding of the causes and natural history of disability resulting from back pain. Methods. Subjects were 1213 enrollees of a Health Maintenance Organization (HMO) who consulted a primary care physician for back pain in 1989-1990, completed a baseline telephone interview, and had a follow-up evaluation after 1 and 2 years, using a modified version of the Roland-Morris Scale to measure disability. Results. Subjects who completed 13 years or more of schooling had less disability and a greater decline in their disability over time than those who completed less schooling. Occupational characteristics and somatization were among the strongest explanatory factors. Cigarette smoking contributed to the explanation of the cross-sectional association. Conclusions. Education is associated cross-sectionally and longitudinally with disability resulting from back pain. A wide range of variables may mediate the education-back- related disability association, including a propensity to report diffuse physical symptoms (somatization), lifestyle (e.g., cigarette smoking), and occupational factors.

KW - back pain

KW - disability

KW - educational status

UR - http://www.scopus.com/inward/record.url?scp=0029566220&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029566220&partnerID=8YFLogxK

M3 - Article

VL - 20

SP - 2721

EP - 2730

JO - Spine

JF - Spine

SN - 0362-2436

IS - 24

ER -