Which population groups are at risk and why?
This section will focus on core epidemiological issues that take account of fixed risk factors (such as age, gender, ethnicity, family history) and modifiable risk factors (such as behaviour). The wider determinants of health (such as housing, transport and environment) are also considered.
Age
Older Adults (aged 70 and over) bear the highest burden of musculoskeletal disorders globally (measured by DALYs)1. Older people experience musculoskeletal issues due to age-related changes and lifestyle factors.
Gender
There is a higher prevalence of MSK conditions in women2, and being female is a non-modifiable risk factor which is one of several non-modifiable risk factors including increasing age and onset of menopause3. Data relating to musculoskeletal changes occurring with gender-affirming hormone therapy (GAHT) and gender-affirming surgery is limited, however it is known that transgender women have lower bone mineral density prior to GAHT than cisgender men4.
Socioeconomic status
Those living in a socioeconomically disadvantaged area report higher rates of MSK problems and are more likely to develop it at a younger age5. This is related to employment types. People who live in the most deprived fifth of society are more likely to report arthritis or a long-term MSK condition compared to those in the least deprived fifth6.
Qualifications
Individuals with lower educational attainment are more likely to experience MSK pain and related functional limitations compared to those with higher education7.
Mental health
Individuals suffering from mental health conditions are more likely to develop MSK disorders8.
Ethnicity
Pakistani and black Caribbean groups were most likely to report a long-term MSK condition from Health Survey for England data from 2012 to 20185. It is also reported that White British ethnic group and Black African ethnic group report long-term MSK conditions6.
Prisoners
There is little research relating to MSK conditions and prisoners. However, these individuals experience a higher burden of communicable and non-communicable disease than the general population. The prison population is ageing in most high-income countries which is known to be a risk-factor9.
Sexual Orientation
Research suggests that sexual minority men (but not women) are at greater risk for poor bone health relative to heterosexuals10.
Vulnerable Children
Preventable, non-work-related risk factors are associated with higher risk of musculoskeletal disorders in children and adolescents including: malnutrition and overweight; very low and very high levels of physical activity, leisure activities and poor sleep; smoking and alcohol consumption; bad or incorrect postures caused by extended sitting, excessive use of electronic devices, backpack loads or playing an instrument; sports injuries; mental health problems; social status; and weather conditions11. Some of which may be applicable to vulnerable children.