Inequalities in the management of back pain care in Brazil - National Health Survey, 2019

Abstract 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.