ArticleBMC musculoskeletal disorders2024
Association of neighborhood-level disadvantage beyond individual sociodemographic factors in patients with or at risk of knee osteoarthritis.
Article in BMC musculoskeletal disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Neighborhood disadvantage and menstrual disturbances in a preconception cohort.Fertility and sterility · 2026Article
- Structural and individualized racism drives racial disparities in chronic low back pain: A cross-sectional serial mediation analysis.The journal of pain · 2026Article
- Associations between neighborhood disadvantage, cannabis use, and patient-reported outcomes among patients with cancer.Drug and alcohol dependence reports · 2026Article
- Physician Referral Patterns to Physical Therapists for Managing Knee Osteoarthritis: A Retrospective Analysis of Electronic Health Records From an Integrated Health System.Arthritis care & research · 2026Article
- Understanding risk and protective factors for pain and healthy aging: an intersectional and resilience-based perspective.Frontiers in pain research (Lausanne, Switzerland) · 2026Review
- Sex-based associations between neighborhood disadvantage and brain-gut alterations in individuals with irritable bowel syndrome.Biology of sex differences · 2025Article
- Examining associations among daily discrimination, psychosocial risk factors, and pain outcomes in people with chronic low back pain.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
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Abstract
objectiveLower socioeconomic status (SES) is a risk factor for poorer pain-related outcomes. Further, the neighborhood environments of disadvantaged communities can create a milieu of increased stress and deprivation that adversely affects pain-related and other health outcomes. Socioenvironmental variables such as the Area Deprivation Index, which ranks neighborhoods based on socioeconomic factors could be used to capture environmental aspects associated with poor pain outcomes. However, it is unclear whether the ADI could be used as a risk assessment tool in addition to individual-level SES.
methodsThe current study investigated whether neighborhood-level disadvantage impacts knee pain-related outcomes above sociodemographic measures. Participants were 188 community-dwelling adults who self-identified as non-Hispanic Black or non-Hispanic White and reported knee pain. Area Deprivation Index (ADI; measure of neighborhood-level disadvantage) state deciles were derived for each participant. Participants reported educational attainment and annual household income as measures of SES, and completed several measures of pain and function: Short-form McGill Pain Questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index, and Graded Chronic Pain Scale were completed, and movement-evoked pain was assessed following the Short Physical Performance Battery. Hierarchical linear regression analyses were used to assess whether environmental and sociodemographic measures (i.e., ADI 80/20 [80% least disadvantaged and 20% most disadvantaged]; education/income, race) were associated with pain-related clinical outcomes.
resultsLiving in the most deprived neighborhood was associated with poorer clinical knee pain-related outcomes compared to living in less deprived neighborhoods (ps < 0.05). Study site, age, BMI, education, and income explained 11.3-28.5% of the variance across all of the individual pain-related outcomes. However, the ADI accounted for 2.5-4.2% additional variance across multiple pain-related outcomes.
conclusionThe ADI accounted for a significant amount of variance in pain-related outcomes beyond the control variables including education and income. Further, the effect of ADI was similar to or higher than the effect of age and BMI. While the effect of neighborhood environment was modest, a neighborhood-level socioenvironmental variable like ADI might be used by clinicians and researchers to improve the characterization of patients' risk profile for chronic pain outcomes.
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