Multi-Dimensional Impact of Chronic Low Back Pain among Underserved African American and Latino Older Adults

Abstract

Chronic low back pain is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. The existing low back pain research has relied almost exclusively on White/Caucasian participant samples. This study examines the correlates of chronic low back pain among a sample of underserved urban African American and Latino older adults. Controlling for age, gender, race/ethnicity, education, living arrangement, and number of major chronic conditions, associations between low back pain and the following outcome variables are examined: (1) healthcare utilization, (2) health-related quality of life (HR-QoL) and self-rated quality of health; and (3) physical and mental health outcomes. Methods: We recruited nine hundred and five (905) African American and Latino older adults from the South Los Angeles community using convenience and snowball sampling. In addition to standard items that measure demographic variables, our survey included validated instruments to document HR-QoL health status, the Short-Form McGill Pain Questionnaire-2, Geriatric Depression Scale, sleep disorder, and healthcare access. Data analysis includes bivariate and 17 independent multivariate models. Results: Almost 55% and 48% of the Latino and African American older adults who participated in our study reported chronic low back pain. Our data revealed that having low back pain was associated with three categories of outcomes including: (1) a higher level of healthcare utilization measured by (i) physician visits, (ii) emergency department visits, (iii) number of Rx used, (iv) a higher level of medication complexity, (v) a lower level of adherence to medication regimens, and (vi) a lower level of satisfaction with medical care; (2) a lower level of HR-QoL and self-assessment of health measured by (i) physical health QoL, (ii) mental health QoL, and (iii) a lower level of self-rated health; and (3) worse physical and mental health outcomes measured by (i) a higher number of depressive symptoms, (ii) a higher level of pain, (iii) falls, (iv) sleep disorders, (v) and being overweight/obese. Discussion: Low back pain remains a public health concern and significantly impacts the quality of life, health care utilization, and health outcomes of underserved minority older adults. Multi-faceted and culturally sensitive interventional studies are needed to ensure the timely diagnosis and treatment of low back pain among underserved minority older adults. Many barriers and challenges that affect underserved African American and Latino older adults with low back pain simply cannot be addressed in over-crowded EDs. Our study contributes to and raises the awareness of healthcare providers and health policymakers on the necessity for prevention, early diagnosis, proper medical management, and rehabilitation policies to minimize the burdens associated with chronic low back pain among underserved older African American and Latino patients in an under-resourced community such as South Los Angeles.

Influence of the Cognitive and Emotional Status of Patients with Chronic Pain on Treatment Success (Reduction in Pain Intensity and Adherence to Pharmacotherapy): A Prospective Study

“…Therefore, this result should be taken as preliminary data. Observing the age variable, studies indicate that older adults show a lower level of adherence [ 40 , 41 ], which was confirmed by the results of this study. It is necessary to emphasize that age was not associated with adherence to treatment after controlling for other factors.…”

Successful Aging for Community-Dwelling Older Adults: An Experimental Study with a Tablet App

“…Low literacy leads to low health literacy, which often implies unhealthy lifestyles, more chronic conditions (hypertension, diabetes etc. ), and higher mortality rates [ 11 , 12 ]. Inadequate income makes appropriate medical care unattainable, which can increase the chances of disability and lower the quality of life.…”

Chronic Low Back Pain: Prevalence, Impact on Quality of Life, and Predictors of Future Disability

“…It affects QOL through pain, functional disability, and psychosocial distress. This significant impact on QOL results in significant costs to society [ 16 , 17 ]. In this work, we estimated the prevalence of cLBP adults who attended primary healthcare centers seeking any medical service and estimated its impact on their QOL.…”