Kevin Pang
PSYC144: Psychobiology and Culture of Pain
Fall 2003
Final Project
Paper 2: Socioeconomic Status and Back Pain Disability
This unpublished case study, performed by a group in Norway comes to a
rather straightforward conclusion. Through census data, the testers discovered
that there was a "stepwise monotonic relationship between socioeconomic
position and disability retirement from back pain...that...could not be
solely related to manual vs. non-manual jobs".(2) Early retirement, they argued,
is the extreme endpoint of a disabling injury. Being rendered unable to work
is a great burden to the individual and only happens in dire situations.
Although the case study offers no conclusions about why this trend exists, I
believe it backs up my hypothesis. It suggests that the lower
class is much more likely to under treat or ignore their pain. Disability retirement
from back pain is often the result of repeated stress on the back. Without
proper care or protection, the back eventually gives out, disabling the victim. The reason the poor
community is at higher risk to being disabled from work is because of their
negligence towards their health. Although this paper does refute my hypothesis that pain can be
attributed solely to the poor community having more physically demanding jobs,
it does not disprove its influence entirely. The undertreatment of pain
demonstrated in this test can be attributed to the dependence on perceived
physical health mentioned in the hypothesis and insufficient knowledge on how
to treat and prevent long term injuries from developing.
The dependence on perceived physical health is a phenomena we have discussed before in
class. Case studies such as Sherman's "Sensitivity of Pain" reveal that
physical laborers are much less expressive of their pain.(5) Whether that is a
result of their grueling occupation, a front to demonstrate their manhood, or,
in my opinion, a developed instinct to avoid being seen as weak and incapable
of performing their job is difficult to determine. However, it seems
reasonable that poor workers would be less likely to bring up issues regarding
their health than rich workers. They lack the financial security to obtain
proper health care and can not afford to lose their jobs for a significant
amount of time. This results in a large amount of undertreated injuries and
unecessary pain, increasing the chance for serious, long term injuries
in the future.
As for lack of knowledge, paper 1 shows a clear link between the
obliviousness of the lower class and the amount of pain a person endures.
This test reenforces that link stating that "education...
appeared to have an impact on disability retirement...each year of formal
education was independently associated with decreased risk for disability
retirement".(2) This statement agrees with my hypothesis that lack of
knowledge results in the lower class enduring more pain.
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