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Closing the care gap for chronic back pain
By Wendy Haaf
With support from a new fellowship program, postdoctoral scholar Amanuel Samago, PhD, investigates barriers to care for older Canadians
By Wendy Haaf
Before Amanuel Samago, PhD, came to Canada from Ethiopia in 2024, the idea that people could lack adequate access to health care in a wealthy nation seemed as alien as the frigid weather that greeted him on his arrival in Saskatchewan.
“It was a shock,” he said with a wry smile. “I think it was minus 33.”
Samago’s introduction to the Canadian health system as a researcher has been equally eye-opening. And today, with support from the new Schulich Postdoctoral Fellowship Program, he is studying a significant gap in care with the aim of helping to close it.
“We are conducting a systematic review examining how unmet needs affect the health outcomes and health-care use of older Canadians living with chronic back pain,” he said.
The condition affects an estimated one in four Canadians aged 65 and older. According to the World Health Organization, it causes more limitations in functioning among older adults than any other age group. Active rehabilitation remains the cornerstone of treatment.
As a member of the fellowship program’s inaugural cohort, Samago is building on the earlier work of his supervisor, Jessica Wong, PhD, an epidemiologist and assistant professor in the Faculty of Health Sciences' School of Physical Therapy, with a cross-appointment to the Department of Epidemiology and Biostatistics.
“When older adults living with chronic back pain don’t receive the care they need, it’s often due to structural barriers such as cost, wait times, transportation issues and availability of services,” Wong said.
The initial phase of Samago’s research uses data from the Canadian Longitudinal Study on Aging.
“The preliminary findings suggest there is a high level of unmet need,” he said. “Obviously, in Ethiopia, which is a low-income country, unmet health-care need is very high, but I didn’t expect that in Canada.”
Samago’s interest in public health and epidemiology was sparked during his boyhood in a rural area of the East African country. “In the place I grew up, many mothers died at home without any support during childbirth,” he said. “I started asking why services weren’t accessible, particularly for underserved populations, like mothers, children and older adults.”
Those early experiences spurred Samago to study public health at Hawassa University, where he received a PhD in the field. He also has a PhD in epidemiology from the University of Navarra in Spain. His work focused on maternal and child health, including a series of initiatives aimed at learning what prevented women from accessing prenatal care and improving uptake. “One of these projects increased maternal health service utilization by 27 per cent in a particularly underserved population in a rural area,” Samago said.
At the University of Saskatchewan, Samago studied the prevalence of rheumatoid arthritis among older Canadians, including factors contributing to ethnic disparities. In addition to his postdoctoral fellowship, he received funding from the Canadian Institutes for Health Research, which will extend his stay at Western through 2028.
"Amanuel brings rich experience in advanced statistical analysis and research design,” Wong said. “Postdoctoral training is an important bridge to becoming an independent researcher, but it’s also a two-way relationship. I’m constantly learning from Amanuel, and the fellowship has provided invaluable support.”
For his part, Samago is grateful for the experience he’s gaining. Beyond research, he is developing mentorship skills and currently supervises four graduate students from diverse backgrounds – an experience he says is strengthening his ability to support the next generation of researchers.
The questions that first inspired his career continue to guide him. “I hope my research findings will help inform health policies to improve the quality, accessibility and equity of care for older Canadians living with chronic back pain,” he said.