{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:20:38Z","timestamp":1760059238315,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T00:00:00Z","timestamp":1748649600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The spine is the most affected region, which compromises functionality and generates absenteeism, increased health care costs, and disability retirement rates. Based on the biopsychosocial model, it is believed that chronic back problems are the result of a complex network of factors, both individual and contextual. A cross-sectional study was developed with data from the 2013 National Health Survey, the United Nations Development Programme, and the National Register of Health Establishments (state level) for the second and third levels of aggregation, respectively. Multilevel Poisson regression was performed at three levels. The prevalence of chronic back problems was 18.5% (95% CI 17.8; 19.1), with a higher prevalence in females (RP = 1.23; 95% CI 1.15; 1.30), those aged above 49 years (RP = 1.75; 95% CI 1.61; 1.90), those performing heavy activities at work (RP = 1.37; 95% CI 1.28; 1.46), those with depressive days (RP = 1.70; 95% CI 1.50; 1.94), those who were smokers (RP = 1.37; 95% CI 1.27; 1.48), and those in states with a higher coefficient of Family Health Support Team per 100,000 inhabitants (PR = 1.28; 95% CI 1.07; 1.54). Chronic spine problems were associated with biological and behavioral factors and were more strongly associated with the coefficient of Family Health Support Team in Brazilian municipalities.<\/jats:p>","DOI":"10.3390\/ijerph22060879","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T03:57:18Z","timestamp":1748923038000},"page":"879","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Individual and Contextual Factors with Chronic Spine Problems: An Analysis from the National Health Survey"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9139-5540","authenticated-orcid":false,"given":"Aryostennes Miqu\u00e9ias da Silva","family":"Ferreira","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz 59200-000, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanderson Jos\u00e9 Costa de","family":"Assis","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00e9cio Gabriel de","family":"Souza","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz 59200-000, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7320-5520","authenticated-orcid":false,"given":"Geronimo Jos\u00e9 Bouzas","family":"Sanchis","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebeca Freitas de Oliveira","family":"Nunes","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz 59200-000, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcello Barbosa Otoni Gon\u00e7alves","family":"Guedes","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9679-5287","authenticated-orcid":false,"given":"Johnnatas Mikael","family":"Lopes","sequence":"additional","affiliation":[{"name":"Department of Medicine, Federal University of Vale do S\u00e3o Francisco, Paulo Afonso 56304-917, BA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo Giuseppe","family":"Roncalli","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Federal University of Rio Grande do Norte, Natal 59078-900, RN, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e085645","DOI":"10.1136\/bmjopen-2024-085645","article-title":"Exploring the association between Frailty Index and low back pain in middle-aged and older Chinese adults: A cross-sectional analysis of data from the China Health and Retirement Longitudinal Study (CHARLS)","volume":"14","author":"Qing","year":"2024","journal-title":"BMJ Open"},{"key":"ref_2","unstructured":"GBD 2021 Diseases and Injuries Collaborators (2024). 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