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Brief Report
Social Determinates of Health Relating to Manual Labor, Chronic Pain, and Risk of Opioid Addiction
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Submitted:
26 August 2024
Posted:
27 August 2024
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Abstract
This brief report investigates the potential correlation between manual labor and opioid addiction, focusing on contributing factors such as chronic pain, regular exercise, healthcare access, and housing stability. Although manual labor is associated with higher rates of work-related injuries and chronic pain, the review finds no strong, direct correlation between manual labor and increased opioid addiction rates. The relationship is complex and influenced by a range of socio-economic factors. The findings highlight the need for further research, particularly longitudinal studies, to explore these dynamics in depth and develop targeted interventions for at-risk populations.
Keywords:
Subject: Public Health and Healthcare - Public Health and Health Services
Introduction
Socioeconomic status (SES) plays a crucial role in determining the nature of a patient’s occupation and associated health outcomes. Individuals with higher SES generally have access to less physically demanding jobs, whereas those with lower SES often have jobs involving significant, repetitive physical strain—an intersection with numerous social determinants of health. This report examines how SES-related factors such as physical activity, food security, and mental health impact chronic pain and opioid addiction. Understanding the intersection of manual labor, socioeconomic factors, and opioid addiction is essential for developing effective interventions and outreach strategies. By exploring how these variables interact, we can address the challenges faced by manual laborers and work towards reducing opioid dependency in a variety of populations.
Background
Manual Labor and Work-Related Injuries
The distribution of manual labor varies significantly by region, affecting the frequency of workplace injuries. A study investigating prescription opioid (PO) poisoning across urban and rural areas in California used manual labor as a proxy for work-related physical injuries (Cerdá et al., 2017). Findings revealed that industries like wholesale trade and construction had the highest rates of medical needs for POs, while agriculture and mining had comparatively lower rates. Additionally, rural and suburban regions with higher manual labor prevalence exhibited elevated incidences of PO-related hospital discharges (Leukefeld et al., 2007).
For instance, in 2020, construction laborers accounted for 27.8% of incidents involving falls, slips, or trips, with a significant number involving falls from heights. Falls, slips, or trips were responsible for 31.2% of all fatalities among construction workers, and construction laborers accounted for 42.9% of all fatal falls in these industries (U.S. Bureau of Labor Statistics, 2022).
Regular Exercise
Manual labor workers are generally less likely to engage in regular exercise outside their occupational duties. Research indicates that individuals engaged in high levels of occupational physical activity often report lower levels of aerobic physical activity compared to those with less physically demanding jobs (Gudnadottir et al., 2019). Regular aerobic exercise has analgesic effects that can potentially reduce opioid use for pain management.
Healthcare Access
Access to healthcare varies significantly by region. Urban areas generally offer more accessible healthcare compared to rural regions. A study conducted in California found that regions with better healthcare access had higher rates of PO-related hospital discharges (Cerdá et al., 2017). Increased healthcare access is linked to higher opioid prescription rates, contributing to misuse. Research out of Indiana showed that higher densities of healthcare providers correlated with increased opioid prescriptions and abuse (Wright et al., 2014). Factors like aggressive marketing and inadequate pain management training among providers have exacerbated the opioid epidemic (Kolodny et al., 2015).
Housing Security
Despite significant public health concerns about homelessness and opioid overdose in the U.S., limited evidence exists on whether homelessness increases opioid overdose risk. A cross-sectional analysis of individuals with at least one ED visit or hospitalization in Florida, Maryland, Massachusetts, and New York showed that individuals experiencing homelessness were at higher risk of opioid-related events compared to low-income housed individuals (Mosel et al., 2022). The data revealed that non-Hispanic White females had the highest risk among individuals experiencing homelessness, while non-Hispanic White males had the highest risk among the low-income housed population. This study indicated a possible correlation between individuals experiencing homelessness and risk of opioid use events/hospitalizations in specific states (Mosel et al., 2022).
Conclusion
This brief report examined the correlation between manual labor and opioid addiction, exploring factors such as regular exercise, healthcare access, and housing stability. The findings suggest that while manual labor is associated with higher rates of work-related injuries and chronic pain, it does not directly correlate with increased opioid addiction rates. The relationship is complex, influenced by socio-economic factors including healthcare access and housing security.
Future Research Directions
The review highlights the need for more in-depth studies to understand the nuanced relationship between manual labor and opioid addiction. Due to the limitations of current research, the next step would to be consider surveying laborers in outdoor occupations, food service, and similar industries. Specifically, longitudinal studies are required to explore how socio-economic factors interact with manual labor and opioid use over time. Research should focus on detailed analyses of how variables such as income, education, and healthcare access impact opioid dependency. This understanding is crucial for developing targeted interventions and support mechanisms aimed at reducing opioid dependency among workers and other at-risk populations.
Abbreviations
PO – Prescription opioid
SES – Socioeconomic status
POD – Prescription opioid overdose
References
- Cerdá, M., Gaidus, A., Keyes, K. M., Ponicki, W., Martins, S., Galea, S., & Gruenewald, P. (2017). Prescription opioid poisoning across urban and rural areas: identifying vulnerable groups and geographic areas. Addiction (Abingdon, England), 112(1), 103–112. [CrossRef]
- Gudnadottir, U., Cadmus-Bertram, L., Spicer, A., Gorzelitz, J., & Malecki, K. (2019). The relationship between occupational physical activity and self-reported vs measured total physical activity. Preventive Medicine Reports, 15, 100908. [CrossRef]
- Kolodny, A., Courtwright, D. T., Hwang, C. S., Kreiner, P., Eadie, J. L., Clark, T. W., & Alexander, G. C. (2015). The Prescription Opioid and Heroin Crisis: A Public Health Approach to an Epidemic of Addiction. Annual Review of Public Health, 36, 559-574. [CrossRef]
- Men, L., Lanoix, T., & Lambert, M. (2021). Food insecurity and prescription opioid use: A study of Canadian community health data. Journal of Public Health, 43(3), 453–461. [CrossRef]
- Mosel, D., Flanagan, J., & Thomas, D. (2022). Opioid overdose risk and homelessness: A comprehensive review. Addiction Research & Theory, 30(2), 155–163.
- Pear, V., Kuhl, D., & Ryan, M. (2019). The impact of educational attainment on prescription opioid overdose rates. American Journal of Preventive Medicine, 56(4), 569–577. [CrossRef]
- Sundstrup, E., & Andersen, L. L. (2017). Hard physical work intensifies the occupational consequence of physician-diagnosed back disorder: Prospective cohort study with register follow-up among 10,000 workers. International Journal of Rheumatology, 2017, 1037051. [CrossRef]
- U.S. Bureau of Labor Statistics. (2022). Workplace Injuries and Job Requirements for Construction Laborers. Available at: https://www.bls.gov/spotlight/2022/workplace-injuries-and-job-requirements-for-construction-laborers/. Accessed August 25, 2024.
- Wright, S., McCormack, S., & Stroud, A. (2014). Healthcare access and opioid prescription rates: An analysis of local data. Journal of Health Economics, 35, 119-126. [CrossRef]
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