Objectives Several studies have suggested that local socioeconomic factors have a significant impact on health outcomes, independent of individual health and socioeconomic factors, access to medical care, etc. Whether these effects are significant for work disability is less clear. This study was intended to estimate the impact of regional socioeconomic (SE) factors on length of disability (LOD) and medical costs due to occupational low back pain (LBP). Methods Multivariate multilevel regression analysis of medical costs and LOD in a large retrospective cohort of occupational LBP cases from 49 US states (n=59,360), using a large Workers’ Compensation (WC) administrative database, with a minimum of one year of longitudinal observation for each case. Results After adjustment for multiple individual factors and state WC policy differences, lower neighborhood median household income (MHI) and higher state unemployment rate were associated with longer LOD. Medical costs were significantly higher in cases from neighborhoods with higher MHI, less rural populations, lower average education attainment, and more racial and ethnic minorities. Medical costs were significantly lower in cases from states with a higher proportion of workers receiving Social Security Disability Insurance. Conclusions There are significant regional SE disparities in medical costs and LOD due to occupational LBP, even when multiple potential confounders are addressed, and health insurance type, wage replacement benefits, and access to health care are mostly uniform. The findings suggest opportunities to improve work disability outcomes through improving access to high-quality-care in disadvantaged regions; the result also suggest that regions with high level of access to care, but of poor quality, have worse outcomes.

Conference Title

Fourth Work Disability Prevention & Integration: Work Disability Prevention Knowledge

Conference Country

Netherlands

Conference Date

Sept. 25, 2016 - Sept. 28, 2016

Conference Sponsor

VU UNIVERSITY MEDICAL CENTER AND THE ACADEMIC MEDICAL CENTER IN AMSTERDAM

Additional Info

Conference Website