Increased Prevalence of Chronic Disease in Back Pain Patients Living in Car-dependent Neighbourhoods in Canada: A Cross-sectional Analysis

Amy Zeglinski-Spinney; Denise C. Wai; Philippe Phan; Eve C. Tsai; Alexandra Stratton; Stephen P. Kingwell; Darren M. Roffey; Eugene K. Wai

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자료유형: 학술저널

저자정보: Amy Zeglinski-Spinney Denise C. Wai Philippe Phan Eve C. Tsai Alexandra Stratton Stephen P. Kingwell Darren M. Roffey Eugene K. Wai

저널정보: 대한예방의학회 예방의학회지 예방의학회지 제51권 제5호

발행연도: 2018.1

수록면: 227 - 233 (7page)

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Objectives: Chronic diseases, including back pain, result in significant patient morbidity and societal burden. Overall improvement in physical fitness is recommended for prevention and treatment. Walking is a convenient modality for achieving initial gains. Our objective was to determine whether neighbourhood walkability, acting as a surrogate measure of physical fitness, was associated with the presence of chronic disease. Methods: We conducted a cross-sectional study of prospectively collected data from a prior randomized cohort study of 227 patients referred for tertiary assessment of chronic back pain in Ottawa, ON, Canada. The Charlson Comorbidity Index (CCI) was calculated from patient-completed questionnaires and medical record review. Using patients’ postal codes, neighbourhood walkability was determined using the Walk Score, which awards points based on the distance to the closest amenities, yielding a score from 0 to 100 (0-50: car-dependent; 50-100: walkable). Results: Based on the Walk Score, 134 patients lived in car-dependent neighborhoods and 93 lived in walkable neighborhoods. A multivariate logistic regression model, adjusted for age, gender, rural postal code, body mass index, smoking, median household income, percent employment, pain, and disability, demonstrated an adjusted odds ratio of 2.75 (95% confidence interval, 1.16 to 6.53) times higher prevalence for having a chronic disease for patients living in a car-dependent neighborhood. There was also a significant dose-related association (p=0.01; Mantel-Haenszel chi-square=6.4) between living in car-dependent neighbourhoods and more severe CCI scores. Conclusions: Our findings suggest that advocating for improved neighbourhood planning to permit greater walkability may help offset the burden of chronic disease.

참고문헌 (22)

참고문헌 신청

Bauer UE / 2014 / Prevention of chronic disease in the 21st century: elimination of the leading preventable causes of premature death and disability in the USA / Lancet 384(9937):45~52

Gore M / 2012 / The burden of chronic low back pain: clinical comorbidities, treatment patterns, and health care costs in usual care settings / Spine (Phila Pa 1976) 37(11):E668~E677

Ding D / 2017 / The economic burden of physical inactivity: a systematic review and critical appraisal / Br J Sports Med 51(19):1392~1409

Katzmarzyk PT / 2000 / The economic burden of physical inactivity in Canada / CMAJ 163(11):1435~1440

Roffey DM / 2013 / Obesity and low back pain: is there a weight of evidence to support a positive relationship? / Curr Obes Rep 2(3):241~250

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