One potential reason for the increase may be increasing rates of obesity. North Carolinians have grown considerably more obese (BMI ≥30) over the period we examined (13.4% in 1992 to 26.6% in 2006).(47) Whether obesity is a risk factor for LBP, however, is still unclear.(48–50) Changes in psychosocial and physical work demands, risk factors for LBP,(51) may have also contributed to the increase in prevalence. The workforce in North Carolina has changed over the past 15 years with decreases in the percentage of manufacturing jobs and increases in the percentage of construction and service industry jobs.(