Study: Sociodemographic Pain Disparity Higher Than Previously Thought
According to a recent study, lower socioeconomic status and education levels are associated with higher degrees of chronic pain and severe chronic pain.
The study used 12 years of data from the Health and Retirement study from 1998-2010, which included 19,776 participants 51 years and older. Participants were asked to rate their pain as mild, moderate, or severe, and to rate their ability to work or perform daily tasks. Participants were excluded if they were being treated for cancer.
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Researchers estimated disparities in chronic pain based on sociodemographic factors, and investigated whether pain severity, reporting heterogeneity, survey nonresponse, and morality selection might bias social disparity estimates of pain. In addition, researchers examined whether the plateauing of pain above age 60, and lower pain in race and ethnic minorities were supported by evidence.
Their findings showed a high prevalence of chronic pain: 27.3% at the start of the study and increasing to 36.6%.
“Multivariate latent growth curve models reveal extremely large disparities in pain by sex, education, and wealth, which manifest primarily as differences in intercept. Net of these variables, there is no racial/ethnic minority disadvantage in pain scores, and indeed a black advantage vis-à-vis whites,” wrote Hanna Grol-Prokopczyk, an assistant professor of sociology at the University of Buffalo.
Education level showed high degrees of disparity as people with the least amount of education had an 80% increased risk for chronic pain compared to those who had the most. Participants who did not finish high school were 370% more likely to experience severe chronic pain compared to those with graduate degrees.
In addition, researchers did not find any evidence of bias in pain-related surveys, but survey that did not report on heterogeneity or account for pain severity were likely to underestimate socioeconomic disparities related to pain.
Plateauing of pain levels was not supported by evidence, according to the study. Instead, pain levels appeared to be rising by birth cohort with more pain reported by people in their 60s during 2010 compared to pain reported by people in their 60s in 1998.
“If you’re looking at all pain – mild, moderate and severe combined – you do see a difference across socioeconomic groups. And other studies have shown that. But if you look at the most severe pain, which happens to be the pain most associated with disability and death, then the socioeconomically disadvantaged are much, much more likely to experience it.”
Additional research is needed to address the socioeconomic disparity in pain, and to identify other treatments for the management of chronic pain.
—Melissa Weiss
Reference:
- Grol-Prokopczyk H. Sociodemographic disparities in chronic pain, based on 12-year longitudinal data. Pain 158 (2): 313-322.
- Gambini B. Poor and less educated suffer the most from chronic pain [press release]. Buffalo, New York: University of Buffalo; February 6, 2017. http://www.buffalo.edu/news/releases/2017/02/009.html