Virginia Via Research Day Book 2026

Medical Student Research Public Health

08 ADVERSE SOCIAL DETERMINANTS AND COMORBIDITIES AS DRIVERS OF POOR FUNCTIONAL STATUS AND TREATMENT OUTCOMES IN THOSE WITH CHRONIC LOW BACK PAIN.

Connor Chapman OMSIII, Madison Metheney OMSIII, Dr. Kelly Roballo DVM, PHD. Corresponding authors:cchapman@vcom.edu, metheney@vcom.edu

VCOM-Virginia, Blacksburg, Virginia

Context: Chronic low back pain is a leading cause of health burden in both primary care and surgical settings. Less is known about how social determinants of health, comorbidities, and psychosocial factors influence the course of chronic low back pain with regards to the diagnosis, pain, functional limitation, and treatment. We hope to investigate chronic low back pain with social determinants of health and other factors in mind to further evaluate the condition, but also to reveal another issue at hand, inequality and inequity. Objective and/or Hypothesis: Our objective is to further examine chronic low back pain and its association between social determinants of health (such as race, ethnicity, location, neighborhood, education, and income), comorbidities, and psychosocial factors. We hypothesize that social determinants of health greatly influence chronic back pain. Specifically, we expect that adverse determinants will correlate with worsened pain/functional status. We also hypothesize that chronic low back pain will be elevated in those with comorbidities/psychosocial factors such as obesity, depression, and anxiety. We also expect to reveal inequities among those with adverse social determinants.

Methods: The study design: This study will be a retrospective study looking at existing data using the “All of Us” research platform. We will build cohorts and datasets from the existing data in the platform to examine parameters of interest (such as social determinants of health and corresponding comorbidities). We will then run the data through RStudio (“All of Us” research platform’s analysis tool). Setting: The study does not involve a specific setting as the data is scattered across the United States. Population/sample: The sample size for each parameter will vary based on the existing data in the database (for example: our first parameter assessed, BMI, included 1274 subjects). Variables or outcomes: We will investigate social determinants of health such as race, ethnicity, education, and income status. Comorbidities assessed thus far include obesity. We also plan on looking at depression and anxiety. Data collection methods: Using data from the “All of Us” Research Platform.

Analysis approach: Using the RStudio analysis within the platform. Results/Conclusions: Some results are still tentative, but we expect that one with an increased amount of disadvantageous social determinants of health, comorbidities, and psychosocial histories, will have worse pain/outcomes. We have already found a statistically significant correlation between BMI and back pain. In addition, we found that chronic low back pain is higher in African American populations. Lastly, we have found so far, that social determinants of health and back pain are correlated. We plan on further quantifying this relationship. As stated before, we expect to reveal a correlation between back pain and social determinants of health. In addition, we expect to reveal inequities among certain populations. By identifying multidimensional risk profiles, this may inform risk stratification and allow for better support of diverse health systems and efforts to reduce disparities and dismantle barriers. IRB Statement: NA.

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22 Edward Via College of Osteopathic Medicine (VCOM)