Health disparities paradoxes: Depression and chronic back pain in college alumnae and U.S. women,39–49

Abstract

Aims: In the US, higher SES (socio-economic status) groups and white Americans tend to be “healthier” than less advantaged groups. Elimination of disparities is a major public health goal. This study examines disparities for two highly prevalent medical conditions – depression and chronic back pain – and selected medical conditions and behavioral practices. The aim is to provide evidence that may have public health implications for prevention as well as for treatment. Methods: Data from two groups of women: 1) 1704 college-educated women who responded to a self-report questionnaire; and 2) women whose data are reported in the U.S. Health Interview survey and in epidemiologic studies of depression and chronic back pain were compared for depression, chronic back pain and selected behavioral practices and medical conditions reported by the two groups of women. Results: The percentages reporting depression were 17.6 and 16.6; for chronic back pain 9.6 and 10.2 – non statistically-significant differences. For other conditions, the higher SES women had significantly more favorable outcomes. Conclusions: The paradox of no SES disparities for depression and low back pain raises a number of questions regarding the underlying mechanisms; and also has implications for prevention and treatment strategies of the two highly prevalent conditions.