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Reducing the prevalence of low‐back pain by reducing the prevalence of psychological distress: Evidence from a natural experiment and implications for health care providers
Author(s) -
Brown Timothy T.,
Ahn Christie,
Huang Haoyue,
Ibrahim Zaidat
Publication year - 2020
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13557
Subject(s) - medicine , low back pain , distress , ambulatory , regression discontinuity design , psychiatry , physical therapy , clinical psychology , alternative medicine , pathology
Objective To determine whether exogenously reduced psychological distress reduces reported low‐back pain (LBP) and is associated with reduced medical visits for LBP. Data Sources National Health Interview Survey, National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, 1998‐2004. Study Design We estimate a fuzzy regression discontinuity model in which a discontinuity in the prevalence of psychological distress is identified by exogenous national events. We examine whether this discontinuity induced a corresponding discontinuity in the prevalence of LBP. We additionally estimate a regression discontinuity model to determine associated changes in medical visits with LBP as the primary complaint. Principal Findings The prevalence of LBP was discontinuously reduced by one‐fifth due to the exogenous national discontinuous reduction in psychological distress. This discontinuity in LBP cannot be explained by discontinuities in employment, insurance, injuries/poisoning, general health status, or other factors. We find an associated three‐fifth discontinuous reduction in medical visits with LBP as the primary complaint. Conclusions On a monthly basis, 2.1 million ( P < .01) adults ceased to suffer LBP due to the national reduction in psychological distress, and associated medical visits with LBP as the primary complaint declined by 685 000 ( P < .01).