A new study led by Flavia P. Kapos, DDS, MS, PhD, assistant professor of orthopaedic surgery at Duke University, sheds light on how socioeconomic factors influence the development of high-impact chronic pain (HICP) among adults in the United States. The findings, published in a recent brief report, underscore the urgent need for population-level strategies to address disparities in pain outcomes.
High-impact chronic pain—defined as chronic pain that limits daily activities on most days—is a growing public health concern. While chronic pain affects millions, little is known about specific components of socioeconomic position (SEP) that shape the risk of transitioning into more debilitating, possibly life-altering pain. Kapos and her co-authors, Termeh M. Feinberg, PhD, MPH; Gregory W. Terman, MD, PhD; and Richard L. Nahin, PhD, MPH, set out to fill this gap.
Using nationally representative data from a 2019–2020 cohort of 9,534 adults without high-impact chronic pain at baseline, the researchers analyzed several indicators of SEP, including educational attainment, family income, work status, living arrangement, cost-related medical care avoidance, and food insecurity. Participants were also stratified by baseline pain status: no chronic pain versus low-impact chronic pain (chronic pain that never or only some days limits daily activities).
The study found:
- Overall, one-year cumulative incidence of HICP was 4.3%.
- Individuals with low-impact chronic pain were significantly more likely to develop HICP (14.2%) compared to those with no chronic pain (2.6%).
- Adults with lower SEP were approximately twice as likely to experience the onset of high-impact chronic pain compared to more advantaged peers, after adjusting for relevant variables.
“These findings underscore the significant impact socioeconomic factors have on the development of disabling pain,” Kapos and her team conclude. “Addressing disparities through comprehensive, systemic solutions and enhancing access to effective pain care are essential steps toward improving population health.”
This research provides significant evidence to guide future prevention efforts and supports the need for targeted strategies that reduce inequities in pain outcomes. Kapos’ work continues to advance understanding of the factors that drive chronic pain and shape well-being across diverse communities.