Inequalities in the management of back pain care in Brazil - National Health Survey, 2019/Desigualdades no manejo da dor nas costas no Brasil - Pesquisa Nacional de Saude, 2019

• Published in: Ciência & saude coletiva 2023-02, Vol.28 (2), p.437
• Main Authors: Saes, Mirelle de Oliveira, Saes-Silva, Elizabet, Duro, Suele Manjourany Silva, Neves, Rosalia Garcia
• Format: Article
• Language: Portuguese
• ISSN: 1413-8123
• DOI: 10.1590/1413-81232023282.11792022

The aim was to assess the presence of socioeconomic inequalities in the management of back pain among Brazilians. Cross-sectional study with data from the National Health Survey (2019). The management of back pain care was assessed using five outcomes: regular exercise; physiotherapy; use of medications or injections; integrative and complementary practice; regular follow-up with a health professional. The magnitude of inequalities of each outcome in relation to exposures (education and income) was estimated using two indices: slope index of inequality (SII) and concentration index (CIX). Of the 90,846 interviewees, 19,206 individuals (21.1%) reported some chronic back problem. The most prevalent outcomes were use of medications and injections (45.3%), physical exercise (26.3%) and regular follow-up with a health professional (24.7%). The existence of inequalities in the management of back pain in the Brazilian population was evident. The adjusted analysis showed that the richest and most educated performed two to three times more physical exercise, physiotherapy, integrative and complementary practices (ICPS) and regular follow-up with a health professional than the poorest and least educated. Absolute (SII) and relative (CIX) inequalities were significant for all outcomes. Key words Pain management, Back pain, Health inequity O objetivo foi avaliar a presenca de desigualdades socioeconomicas no manejo da dor nas costas em brasileiros. Estudo transversal com dados da Pesquisa Nacional de Saude (2019). O manejo da dor nas costas foi avaliado por meio de cinco desfechos: exercicios regulares; fisioterapia; uso de medicamentos ou injecoes; pratica integrativa e complementar; acompanhamento regular com profissional de saude. A magnitude das desigualdades de cada desfecho em relacao as exposicoes (escolaridade e renda) foi estimada por meio de dois indices: slope index of inequality (SII) e concentration index (CIX). Dos 90.846 entrevistados, 19.206 individuos (21,1%) relataram algum problema cronico nas costas. Os desfechos mais prevalentes foram uso de medicamentos e injecoes (45,3%), pratica de exercicios fisicos (26,3%) e acompanhamento regular com profissional de saude (24,7%). Ficou evidente a existencia de desigualdades no manejo da dor nas costas entre brasileiros. Analise ajustada mostrou que os mais ricos e com maior escolaridade realizavam duas a tres vezes mais exercicios fisicos, fisioterapia, praticas integrativas e complementares (ICPS) e acompa