Title: Socioeconomic, Sex, and Regional Predictors of Neck Pain Burden in the United States (1990–2021): An Analysis of the Global Burden of Disease Study

Introduction: Neck pain is a major contributor to the US disease burden, yet the impact of gender, geographic region, and socioeconomic status remains unclear.

Methods: The Global Burden of Disease (1990–2021) dataset was used to extract neck pain incidence, prevalence, and disability-adjusted life years (DALY) rates. ANOVA tests analyzed differences by sex and geographic region (Northeast, Midwest, South, West). Correlations were calculated between these outcomes and employment, poverty, and uninsured rates.

Results: The mean neck pain prevalence during the study period was 2,699.7 per 100,000 (95% CI: 2,690.0–2,709.5), highest in the Northeast (2,784.9 [2,761.5–2,808.2]) and lowest in the South (2,654.7 [2,631.9–2,677.5]) (p < 0.001). Similarly, incidence was highest in the Northeast (557.5 [553.9–561.2]) and lowest in the South (538.2 [535.3–541.2]) (p < 0.001). Average DALYs were 266.3 per 100,000 (95% CI: 265.4–267.2), again highest in the Northeast (274.9 [272.1–276.5]) and lowest in the South (259.5 [256.7–262.3]) (p < 0.001). Women showed higher prevalence (3,070.7 [3,062.2–3,079.1]) and DALYs (303.1 [301.8–304.5]) than men (prevalence: 2,324.9 [2,317.3–2,332.6]; DALYs: 227.3 [226.1–228.6]) (p < 0.001). Regression revealed strong negative correlations between uninsured rates and both prevalence (r = -0.8705, p < 0.001) and DALYs (r = -0.9284, p < 0.001), while poverty was weakly linked to DALYs (r = -0.3720, p = 0.036) and unemployment showed no significant association.

Conclusion : The distribution of neck pain burden varies significantly by geographic region and socioeconomic status. Addressing these disparities requires policies focused on equitable support for high-burden groups.