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

BackgroundA geographical analysis could be employed to uncover social risk factors and interventions linked to chronic pain. Nonetheless, geographical variation in chronic pain across different regions of Japan have not been well explored. This study aims to investigate geographical variation in hig...

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Main Authors: Kenta Wakaizumi, Chisato Tanaka, Yuta Shinohara, Yihuan Wu, Saki Takaoka, Morihiko Kawate, Hiroyuki Oka, Ko Matsudaira
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1482177/full
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author Kenta Wakaizumi
Kenta Wakaizumi
Chisato Tanaka
Chisato Tanaka
Yuta Shinohara
Yuta Shinohara
Yihuan Wu
Yihuan Wu
Saki Takaoka
Saki Takaoka
Morihiko Kawate
Morihiko Kawate
Hiroyuki Oka
Ko Matsudaira
author_facet Kenta Wakaizumi
Kenta Wakaizumi
Chisato Tanaka
Chisato Tanaka
Yuta Shinohara
Yuta Shinohara
Yihuan Wu
Yihuan Wu
Saki Takaoka
Saki Takaoka
Morihiko Kawate
Morihiko Kawate
Hiroyuki Oka
Ko Matsudaira
author_sort Kenta Wakaizumi
collection DOAJ
description BackgroundA geographical analysis could be employed to uncover social risk factors and interventions linked to chronic pain. Nonetheless, geographical variation in chronic pain across different regions of Japan have not been well explored. This study aims to investigate geographical variation in high-impact chronic pain (HICP), defined as moderate to severe chronic pain, and examine the associated psychological factors at the prefecture level.MethodsA cross-sectional Internet-based survey involving 52,353 participants was conducted to assess chronic pain conditions, stress levels, mood states, educational levels, living status, regions, sleep duration, and exercise habits. A geographical analysis evaluated the prevalence of HICP at the prefecture level, and a multilevel analysis explored the risk factors for HICP at both individual and prefecture levels.ResultsThe 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%; z-score = −2.45). Geographical maps of Japan indicated that regional-level subjective stress, negative emotions, and short sleep were associated with higher HICP prevalence. In contrast, positive emotions, such as vigor, were associated with lower prevalence. Multilevel analysis revealed a significant improvement in model fit after incorporating psychological factors at the prefecture level (p < 0.001) and identified significant associations between high subjective stress and low vigor at the prefecture level with HICP prevalence (p < 0.001).ConclusionThere are regional differences in HICP prevalence, and at the prefecture level, subjective stress and vigor are associated with HICP.
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spelling doaj-art-28d197c8789f4b7a9435d9653a700c3f2025-08-20T01:59:09ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-12-011210.3389/fpubh.2024.14821771482177Geographical variation in high-impact chronic pain and psychological associations at the regional level: a multilevel analysis of a large-scale internet-based cross-sectional surveyKenta Wakaizumi0Kenta Wakaizumi1Chisato Tanaka2Chisato Tanaka3Yuta Shinohara4Yuta Shinohara5Yihuan Wu6Yihuan Wu7Saki Takaoka8Saki Takaoka9Morihiko Kawate10Morihiko Kawate11Hiroyuki Oka12Ko Matsudaira13Department of Anesthesiology, Keio University School of Medicine, Tokyo, JapanInterdisciplinary Pain Center, Keio University Hospital, Tokyo, JapanDepartment of Anesthesiology, Keio University School of Medicine, Tokyo, JapanInterdisciplinary Pain Center, Keio University Hospital, Tokyo, JapanDepartment of Anesthesiology, Keio University School of Medicine, Tokyo, JapanInterdisciplinary Pain Center, Keio University Hospital, Tokyo, JapanDepartment of Anesthesiology, Keio University School of Medicine, Tokyo, JapanInterdisciplinary Pain Center, Keio University Hospital, Tokyo, JapanDepartment of Anesthesiology, Keio University School of Medicine, Tokyo, JapanInterdisciplinary Pain Center, Keio University Hospital, Tokyo, JapanDepartment of Anesthesiology, Keio University School of Medicine, Tokyo, JapanInterdisciplinary Pain Center, Keio University Hospital, Tokyo, JapanDivision of Musculoskeletal AI System Development, Faculty of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima, JapanBackgroundA geographical analysis could be employed to uncover social risk factors and interventions linked to chronic pain. Nonetheless, geographical variation in chronic pain across different regions of Japan have not been well explored. This study aims to investigate geographical variation in high-impact chronic pain (HICP), defined as moderate to severe chronic pain, and examine the associated psychological factors at the prefecture level.MethodsA cross-sectional Internet-based survey involving 52,353 participants was conducted to assess chronic pain conditions, stress levels, mood states, educational levels, living status, regions, sleep duration, and exercise habits. A geographical analysis evaluated the prevalence of HICP at the prefecture level, and a multilevel analysis explored the risk factors for HICP at both individual and prefecture levels.ResultsThe 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%; z-score = −2.45). Geographical maps of Japan indicated that regional-level subjective stress, negative emotions, and short sleep were associated with higher HICP prevalence. In contrast, positive emotions, such as vigor, were associated with lower prevalence. Multilevel analysis revealed a significant improvement in model fit after incorporating psychological factors at the prefecture level (p < 0.001) and identified significant associations between high subjective stress and low vigor at the prefecture level with HICP prevalence (p < 0.001).ConclusionThere are regional differences in HICP prevalence, and at the prefecture level, subjective stress and vigor are associated with HICP.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1482177/fullhigh impact chronic paingeographical variationsubjective stressprofile of mood statesmultilevel analysis
spellingShingle Kenta Wakaizumi
Kenta Wakaizumi
Chisato Tanaka
Chisato Tanaka
Yuta Shinohara
Yuta Shinohara
Yihuan Wu
Yihuan Wu
Saki Takaoka
Saki Takaoka
Morihiko Kawate
Morihiko Kawate
Hiroyuki Oka
Ko Matsudaira
Geographical variation in high-impact chronic pain and psychological associations at the regional level: a multilevel analysis of a large-scale internet-based cross-sectional survey
Frontiers in Public Health
high impact chronic pain
geographical variation
subjective stress
profile of mood states
multilevel analysis
title Geographical variation in high-impact chronic pain and psychological associations at the regional level: a multilevel analysis of a large-scale internet-based cross-sectional survey
title_full Geographical variation in high-impact chronic pain and psychological associations at the regional level: a multilevel analysis of a large-scale internet-based cross-sectional survey
title_fullStr Geographical variation in high-impact chronic pain and psychological associations at the regional level: a multilevel analysis of a large-scale internet-based cross-sectional survey
title_full_unstemmed Geographical variation in high-impact chronic pain and psychological associations at the regional level: a multilevel analysis of a large-scale internet-based cross-sectional survey
title_short Geographical variation in high-impact chronic pain and psychological associations at the regional level: a multilevel analysis of a large-scale internet-based cross-sectional survey
title_sort geographical variation in high impact chronic pain and psychological associations at the regional level a multilevel analysis of a large scale internet based cross sectional survey
topic high impact chronic pain
geographical variation
subjective stress
profile of mood states
multilevel analysis
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1482177/full
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