Racial and Socioeconomic Disparities in Disabling Chronic Pain: Findings From the Health and Retirement Study

• Published in: The journal of pain Vol. 18; no. 12; pp. 1459 - 1467
• Main Authors: Janevic, Mary R., McLaughlin, Sara J., Heapy, Alicia A., Thacker, Casey, Piette, John D.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2017
• Subjects: Aged; Aged, 80 and over; Black or African American - statistics & numerical data; Chronic Pain - epidemiology; Chronic Pain - ethnology; Chronic Pain - physiopathology; Disabled Persons - statistics & numerical data; Female; functional status; health disparities; Health Status Disparities; Health Surveys - statistics & numerical data; Humans; Male; Middle Aged; older adults; Quality of life; race/ethnicity; Social Class; survey research; United States - epidemiology; older adults; health disparities; functional status; survey research; Quality of life; race/ethnicity
• ISSN: 1526-5900; 1528-8447
• DOI: 10.1016/j.jpain.2017.07.005

The U.S. National Pain Strategy calls for increased population research on “high-impact chronic pain” (ie, longstanding pain that substantially limits participation in daily activities). Using data from the nationally-representative Health and Retirement Study (HRS), we investigated the prevalence of high-impact chronic pain in U.S. adults older than age 50 overall and within population subgroups. We also explored sociodemographic variation in pain-related disability within specific activity domains. Data are from a subsample of HRS respondents (n = 1,925) who were randomly selected for a supplementary pain module in 2010. Our outcome was operationalized as pain duration of ≥7 months and a disability rating of ≥7 (0–10 scale) in at least 1 domain: family/home, leisure, social activities, work, or basic activities. Overall, 8.2% (95% confidence interval = 6.7–10.1%) of adults older than age 50 met criteria for high-impact chronic pain. This proportion rose to 17.1% (95% confidence interval = 12.3–23.4%) among individuals in the lowest wealth quartile. Prevalence differences according to education, race/ethnicity, and age were not significant. Arthritis and depression were significantly associated with high-impact pain in multivariable analysis. Among adults with any chronic pain, African American and individuals in the lowest wealth quartile reported more pain-related disability across activity domains. High-impact chronic pain is unequally distributed among midlife and older U.S. adults. Efforts to reduce the burden of disabling chronic pain should prioritize socioeconomically vulnerable groups, who may have the least access to multimodal pain treatment to improve function. •The National Pain Strategy calls for population research on high-impact chronic pain.•We examined sociodemographic disparities in such pain in the United States.•Approximately 8% of adults older than age 50 have high-impact chronic pain.•High-impact pain prevalence rose sharply with decreasing household wealth.•Black compared to white adults had greater pain-related disability across domains.