Volume 55 | Number 5 | October 2020

Abstract List

Timothy T. Brown Ph.D., Christie Ahn MPH, Haoyue Huang MTM, Zaidat Ibrahim MPH


To determine whether exogenously reduced psychological distress reduces reported low‐back pain (LBP) and is associated with reduced medical visits for LBP.

Data Sources

National Health Interview Survey, National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, 1998‐2004.

Study Design

We estimate a fuzzy regression discontinuity model in which a discontinuity in the prevalence of psychological distress is identified by exogenous national events. We examine whether this discontinuity induced a corresponding discontinuity in the prevalence of LBP. We additionally estimate a regression discontinuity model to determine associated changes in medical visits with LBP as the primary complaint.

Principal Findings

The prevalence of LBP was discontinuously reduced by one‐fifth due to the exogenous national discontinuous reduction in psychological distress. This discontinuity in LBP cannot be explained by discontinuities in employment, insurance, injuries/poisoning, general health status, or other factors. We find an associated three‐fifth discontinuous reduction in medical visits with LBP as the primary complaint.


On a monthly basis, 2.1 million ( < .01) adults ceased to suffer LBP due to the national reduction in psychological distress, and associated medical visits with LBP as the primary complaint declined by 685 000 ( < .01).