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No man is an island: living in a disadvantaged neighborhood influences chronic pain development after motor vehicle collision.

Publication ,  Journal Article
Ulirsch, JC; Weaver, MA; Bortsov, AV; Soward, AC; Swor, RA; Peak, DA; Jones, JS; Rathlev, NK; Lee, DC; Domeier, RM; Hendry, PL; McLean, SA
Published in: Pain
October 2014

Living in a lower socioeconomic status neighborhood has been shown to alter stress system function and is associated with a number of adverse health outcomes, but its influence on musculoskeletal pain (MSP) outcomes after traumatic stress exposures such as motor vehicle collision (MVC) has not been assessed. We performed a multicenter, prospective study that enrolled 948 European-American individuals within 24 hours of MVC who were discharged home after emergency department evaluation. Follow-up evaluations were completed via telephone or Internet survey 6 weeks, 6 months, and 1 year after MVC on 91%, 89%, and 91% of participants, respectively. A robust aggregate measure of census tract neighborhood disadvantage was derived, and individual-level characteristics assessed included socioeconomic and demographic characteristics, pain prior to MVC, litigation status, and opioid use. MSP was assessed in the emergency department; MSP and pain interference with daily activity were assessed at 6 weeks, 6 months, and 1 year. After adjustment for individual-level factors, living in more disadvantaged neighborhoods was associated with increased MSP (P=0.0009) and increased pain interference with daily function (P<0.0001). The relationship between neighborhood disadvantage and MSP was moderated by a common single nucleotide polymorphism, rs2817038, 5' of the gene encoding FKBP5, a functional regulator of glucocorticoid receptor sensitivity (interaction P-value=0.0015). These data support the hypothesis that low neighborhood socioeconomic status increases the likelihood of worse MSP outcomes after traumatic stress exposures such as MVC, and that this influence is mediated in part via its influence on stress system function.

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Published In

Pain

DOI

EISSN

1872-6623

Publication Date

October 2014

Volume

155

Issue

10

Start / End Page

2116 / 2123

Location

United States

Related Subject Headings

  • Young Adult
  • Vulnerable Populations
  • Tacrolimus Binding Proteins
  • Socioeconomic Factors
  • Social Environment
  • Risk Factors
  • Residence Characteristics
  • Prospective Studies
  • Polymorphism, Single Nucleotide
  • Pain Measurement
 

Citation

APA
Chicago
ICMJE
MLA
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Ulirsch, J. C., Weaver, M. A., Bortsov, A. V., Soward, A. C., Swor, R. A., Peak, D. A., … McLean, S. A. (2014). No man is an island: living in a disadvantaged neighborhood influences chronic pain development after motor vehicle collision. Pain, 155(10), 2116–2123. https://doi.org/10.1016/j.pain.2014.07.025
Ulirsch, Jacob C., Mark A. Weaver, Andrey V. Bortsov, April C. Soward, Robert A. Swor, David A. Peak, Jeffrey S. Jones, et al. “No man is an island: living in a disadvantaged neighborhood influences chronic pain development after motor vehicle collision.Pain 155, no. 10 (October 2014): 2116–23. https://doi.org/10.1016/j.pain.2014.07.025.
Ulirsch JC, Weaver MA, Bortsov AV, Soward AC, Swor RA, Peak DA, et al. No man is an island: living in a disadvantaged neighborhood influences chronic pain development after motor vehicle collision. Pain. 2014 Oct;155(10):2116–23.
Ulirsch, Jacob C., et al. “No man is an island: living in a disadvantaged neighborhood influences chronic pain development after motor vehicle collision.Pain, vol. 155, no. 10, Oct. 2014, pp. 2116–23. Pubmed, doi:10.1016/j.pain.2014.07.025.
Ulirsch JC, Weaver MA, Bortsov AV, Soward AC, Swor RA, Peak DA, Jones JS, Rathlev NK, Lee DC, Domeier RM, Hendry PL, McLean SA. No man is an island: living in a disadvantaged neighborhood influences chronic pain development after motor vehicle collision. Pain. 2014 Oct;155(10):2116–2123.

Published In

Pain

DOI

EISSN

1872-6623

Publication Date

October 2014

Volume

155

Issue

10

Start / End Page

2116 / 2123

Location

United States

Related Subject Headings

  • Young Adult
  • Vulnerable Populations
  • Tacrolimus Binding Proteins
  • Socioeconomic Factors
  • Social Environment
  • Risk Factors
  • Residence Characteristics
  • Prospective Studies
  • Polymorphism, Single Nucleotide
  • Pain Measurement