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ORIGINAL RESEARCH article

Front. Public Health
Sec. Life-Course Epidemiology and Social Inequalities in Health
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1482177

Geographical variation in the high impact chronic pain and psychological associations at a regional level: Multilevel analysis in a large-scale internet-based cross-sectional survey

Provisionally accepted
Kenta Wakaizumi Kenta Wakaizumi 1,2*Chisato Tanaka Chisato Tanaka 1,2Yuta Shinohara Yuta Shinohara 1,2Yihuan Wu Yihuan Wu 1,2Saki Takaoka Saki Takaoka 1,2Morihiko Kawate Morihiko Kawate 1,2Hiroyuki Oka Hiroyuki Oka 3Ko Matsudaira Ko Matsudaira 4
  • 1 Department of Anesthesiology, School of Medicine, Keio University, Tokyo, Japan
  • 2 Interdisciplinary Pain Center, Keio University Hospital, Tokyo, Japan
  • 3 Division of Musculoskeletal AI System Development, Faculty of Medicine, The University of Tokyo, Bunkyo, Tōkyō, Japan
  • 4 Department of Pain Medicine, School of Medicine, Fukushima Medical University, Fukushima, Fukushima, Japan

The final, formatted version of the article will be published soon.

    Background: Geographical analysis can uncover social risk factors and interventions linked to chronic pain.Nonetheless, geographical variations in chronic pain in Japan are not well-explored. This study aims to investigate geographical variations in high-impact chronic pain (HICP), defined as moderate to severe chronic pain, and examine associated psychological factors at the prefectural level. Methods: A cross-sectional internet-based survey with 51,701 participants was conducted, assessing chronic pain conditions, stress levels, mood states, educational levels, living status, regions, sleep duration and excise habits. Geographical analysis examined HICPprevalence at the prefectural level, while multilevel analysis examined risk factors for HICP at both individual and prefectural levels. Results: Geographical analysis revealed that Fukushima exhibited the highest HICP prevalence (23.2%; z-score = 2.11) , Oita ranked second (23.0%; z-score = 2.00), and Okinawa showed the lowest prevalence (14.9%; zscore = -2.45). Geographical maps of Japan indicated that regional-level subjective stress, negative emotions, and short sleep associated with higher HICP prevalence, while positive emotions, such as vigor, were associated with lower prevalence. Multilevel analysis showed a significant improvement of model fitting after incorporation of psychological factors at the prefectural level (p<0.001) and identified significant associations of high subjective stress and low vigor at the prefecture level with the HICP (p<0.001). Conclusion: There is a regional difference in the HICP prevalence and subjective stress and vigour at prefectural level are associated factors for the HICP.

    Keywords: High impact chronic pain, Geographical variation, Subjective stress, Profile of mood states, Multilevel Analysis

    Received: 17 Aug 2024; Accepted: 15 Nov 2024.

    Copyright: © 2024 Wakaizumi, Tanaka, Shinohara, Wu, Takaoka, Kawate, Oka and Matsudaira. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Kenta Wakaizumi, Department of Anesthesiology, School of Medicine, Keio University, Tokyo, Japan

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