Pain Trends Among American Adults, 2002–2018: Patterns, Disparities, and Correlates

Abstract

Determining long-term trends in chronic pain prevalence is critical for evaluating and shaping U.S. health policies, but little research has examined such trends. This study (1) provides estimates of pain trends among U.S. adults across major population groups; (2) tests whether sociodemographic disparities in pain have widened or narrowed over time; and (3) examines socioeconomic, behavioral, psychological, and medical correlates of pain trends. Regression and decomposition analyses of joint, low back, neck, facial/jaw pain, and headache/migraine using the 2002–2018 National Health Interview Survey for adults aged 25–84 (N = 441,707) assess the trends and their correlates. We find extensive escalation of pain prevalence in all population subgroups: overall, reports of pain in at least one site increased by 10%, representing an additional 10.5 million adults experiencing pain. Socioeconomic disparities in pain are widening over time, and psychological distress and health behaviors are among the salient correlates of the trends. This study thus comprehensively documents rising pain prevalence among Americans across the adult life span and highlights socioeconomic, behavioral, and psychological factors as important correlates of the trends. Chronic pain is an important dimension of population health, and demographic research should include it when studying health and health disparities.

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References 104

1. 1.

   Ahmad FB, Rossen LM, Spencer MR, Warner M, & Sutton P (2018 ). Provisional drug overdose death counts (NCHS report). Atlanta, GA: National Center for Health Statistics, Centers for Disease Control and Prevention.

   Not in our library

2. 2.

   Ballantyne JC, & Shin NS (2008 ). Efficacy of opioids for chronic pain: A review of the evidence. The Clinical Journal of Pain, 24, 469–478.

   Not in our library10.1097/ajp.0b013e31816b2f26

3. 3.

   Bartley EJ, & Fillingim RB (2013 ). Sex differences in pain: A brief review of clinical and experimental findings. British Journal of Anaesthesia, 111, 52–58.

   Not in our library10.1093/bja/aet127

4. 4.

   Bell A, & Jones K (2014 ). Another ‘futile quest’? A simulation study of Yang and Land’s hierarchical age-period-cohort model. Demographic Research, 30, 333–360.

   Not in our library10.4054/demres.2014.30.11

5. 5.

   Bell A, & Jones K (2018 ). The hierarchical age-period-cohort model: Why does it find the results that it finds? Quality & Quantity, 52, 783–799.

   Not in our library10.1007/s11135-017-0488-5

6. 6.

   Blewett LA, Rivera Drew JA, King ML, & Williams KCW (2019 ). IPUMS health surveys: National Health Interview Survey, version 6.4 [Data set] Minneapolis, MN: IPUMS.

   Not in our library

7. 7.

   Blinder AS (1973 ). Wage discrimination: Reduced form and structural estimates. Journal of Human Resources, 8, 436–455.

   Not in our library

8. 8.

   Brunello G, Fort M, Schneeweis N, & Winter Ebmer R (2016 ). The causal effect of education on health: What is the role of health behaviors? Health Economics, 25, 314–336.

   Not in our library10.1002/hec.3141

9. 9.

   Carnes D (2011 ). Patterns of chronic pain in the population. International Journal of Osteopathic Medicine, 14(3), 81–85.

   Not in our library

10. 10.

    Carr DB (2016 ). “Pain is a public health problem”—What does that mean and why should we care? Pain Medicine, 17, 626–627.

    Not in our library10.1093/pm/pnw045

11. 11.

    Case A, & Deaton A (2015 ). Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences, 112, 15078–15083.

    Not in our library10.1073/pnas.1518393112

12. 12.

    Chou R, Turner JA, Devine EB, Hansen RN, Sullivan SD, Blazina I, … Deyo RA (2015 ). The effectiveness and risks of long term opioid therapy for chronic pain: A systematic review for a National Institutes of Health Pathways to Prevention workshop. Annals of Internal Medicine, 162, 276–286.

    Not in our library10.7326/m14-2559

13. 13.

    Cleveland WS (1979 ). Robust locally weighted regression and smoothing scatterplots. Journal of the American Statistical Association, 74, 829–836.

    Not in our library

14. 14.

    Cohen M, Quintner J, & Buchanan D (2013 ). Is chronic pain a disease? Pain Medicine, 14, 1284–1288.

    Not in our library10.1111/pme.12025

15. 15.

    Craig KD, & Fashler SR (2013 ). Social determinants of pain. In van Griensven H, Strong J, & Unruh AM (Eds.), Pain: A textbook for therapists (2nd ed., pp. 21–31). Edinburgh, Scotland: Elsevier.

    Not in our library

16. 16.

    Croft P, Blyth FM, & van der Windt D (2011 ). Chronic pain as a topic for epidemiology and public health. In Croft P, Blyth FM, & van der Windt D (Eds.), Chronic pain epidemiology: From aetiology to public health (pp. 3–8). Oxford, UK: Oxford University Press.

    Not in our library

17. 17.

    Dueñas M, Ojeda B, Salazar A, Mico JA, & Failde I (2016 ). A review of chronic pain impact on patients, their social environment and the health care system. Journal of Pain Research, 9, 457–467.

    Not in our library10.2147/jpr.s105892

18. 18.

    Edwards RR (2006 ). Age differences in the correlates of physical functioning in patients with chronic pain. Journal of Aging and Health, 18, 56–69.

    Not in our library10.1177/0898264305280976

19. 19.

    Eriksen J, Sjøgren P, Bruera E, Ekholm O, & Rasmussen NK (2006 ). Critical issues on opioids in chronic non-cancer pain: An epidemiological study. Pain, 125, 172–179.

    Not in our library10.1016/j.pain.2006.06.009

20. 20.
    Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011 · 2014

    No notice
21. 21.

    Feehan AK, & Zadina JE (2019 ). Morphine immunomodulation prolongs inflammatory and postoperative pain while the novel analgesic ZH853 accelerates recovery and protects against latent sensitization. Journal of Neuroinflammation, 16, 100.

    Not in our library10.1186/s12974-019-1480-x

22. 22.

    Fliesser M, Huberts JDW, & Wippert P-M (2017 ). The choice that matters: The relative influence of socioeconomic status indicators on chronic back pain—A longitudinal study. BMC Health Services Research, 17, 800.

    Not in our library10.1186/s12913-017-2735-9

23. 23.

    Freburger JK, Holmes GM, Agans RP, Jackman AM, Darter JD, Wallace AS, … Carey TS (2009 ). The rising prevalence of chronic low back pain. Archives of Internal Medicine, 169, 251–258.

    Not in our library10.1001/archinternmed.2008.543

24. 24.

    Gale CR, Deary IJ, Cooper C, & Batty GD (2012 ). Intelligence in childhood and chronic wide-spread pain in middle age: The National Child Development Survey. Pain, 153, 2339–2344.

    Not in our library10.1016/j.pain.2012.07.027

25. 25.

    Gaskin DJ, & Richard P (2012 ). The economic cost of pain in the United States. Journal of Pain, 13, 715–724.

    Not in our library10.1016/j.jpain.2012.03.009

26. 26.

    Gatchel RJ, Peng YB, Peters ML, Fuchs PN, & Turk DC (2007 ). The biopsychosocial approach to chronic pain: Scientific advances and future directions. Psychological Bulletin, 133, 581–624.

    Not in our library10.1037/0033-2909.133.4.581

27. 27.

    Goosby BJ (2013 ). Early life course pathways of adult depression and chronic pain. Journal of Health and Social Behavior, 54, 75–91.

    Not in our library10.1177/0022146512475089

28. 28.

    Green-Fulgham SM, Ball JB, Kwilasz AJ, Fabisiak T, Maier SF, Watkins LR, & Grace PM (2019 ). Oxycodone, fentanyl, and morphine amplify established neuropathic pain in male rats. Pain, 160, 2634–2640.

    Not in our library10.1097/j.pain.0000000000001652

29. 29.

    Grol-Prokopczyk H (2017 ). Sociodemographic disparities in chronic pain, based on 12-year longitudinal data. Pain, 158, 313–322.

    Not in our library10.1097/j.pain.0000000000000762

30. 30.

    Grol-Prokopczyk H, Luo W, & Karraker A (2017, 4 ). What underlies educational disparities in chronic pain? Paper presented at the annual meeting of the Population Association of America, Chicago, IL.

    Not in our library

31. 31.

    Grol-Prokopczyk H, Zimmer Z, & Zajacova A (2019, 8 ). Have American pain-reporting styles changed over time? An assessment using objective measures of function. Paper presented at the annual meeting of the American Sociological Association, New York, NY

    Not in our library

32. 32.

    Hamilton ER, Hale JM, & Savinar R (2019 ). Immigrant legal status and health: Legal status disparities in chronic conditions and musculoskeletal pain among Mexican-born farm workers in the United States. Demography, 56, 1–24.

    Not in our library10.1007/s13524-018-0746-8

33. 33.

    Hooten WM (2016 ). Chronic pain and mental health disorders: Shared neural mechanisms, epidemiology, and treatment. Mayo Clinic Proceedings, 91, 955–970.

    Not in our library10.1016/j.mayocp.2016.04.029

34. 34.

    Institute of Medicine. (2011 ). Relieving pain in America: A blueprint for transforming prevention, care. Washington, DC: National Academies Press.

    Not in our library

35. 35.

    Interagency Pain Research Coordinating Committee. (2018 ). Federal pain research strategy (Report). Retrieved from https://www.iprcc.nih.gov/federal-pain-research-strategy-overview/federal-research-pain-strategy

    Not in our library

36. 36.

    Janevic MR, McLaughlin SJ, Heapy AA, Thacker C, & Piette JD (2017 ). Racial and socioeconomic disparities in disabling chronic pain: Findings from the Health and Retirement Study. Journal of Pain, 18, 1459–1467.

    Not in our library10.1016/j.jpain.2017.07.005

37. 37.

    Jann B (2008 ). The Blinder Oaxaca decomposition for linear regression models. Stata Journal, 8, 453–479.

    Not in our library

38. 38.

    Jay MA, Bendayan R, Cooper R, & Muthuri SG (2019 ). Lifetime socioeconomic circumstances and chronic pain in later adulthood: Findings from a British birth cohort study. BMJ Open, 9, e024250.

    Not in our library10.1136/bmjopen-2018-024250

39. 39.

    Jones MR, Viswanath O, Peck J, Kaye AD, Gill JS, & Simopoulos TT (2018 ). A brief history of the opioid epidemic and strategies for pain medicine. Pain and Therapy, 7, 13–21.

    Not in our library10.1007/s40122-018-0097-6

40. 40.

    Katz JN (2006 ). Lumbar disc disorders and low-back pain: Socioeconomic factors and consequences. Journal of Bone and Joint Surgery, 88(Suppl. 2), 21–24.

    Not in our library10.2106/jbjs.e.01273

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