The relationship between self-reported severe pain and measures of socio-economic disadvantage

Aims: To determine the association of severe pain with socioeconomic characteristics.

Methods: Data was extracted from the Health Survey for England (HSE), 2005. The HSE is a series of annual cross-sectional surveys designed to describe the health of people living in private homes in England, from a random sample of 720 postcode sectors. Interviewees were ≥ 16 years. Pain severity was characterised by the EQ-5D. Socioeconomic status was classified by ability to work, social security benefits, the National Statistics Socio-economic Classification (NS-SEC) and the Index of Multiple Deprivation (IMD).

Results: Pain status was recorded for 9419 subjects of whom 431 (4.6%) reported severe pain. 156 of those reporting severe pain were of working age. Of these 68 (43.6%) stated they were unable to work due to sickness or disability and 64 (41.0%) claimed a state benefit. After adjusting for disease and demographic variables, severe pain was associated with the IMD with an odds ratio of 1.65 (95% CI 1.16-2.34, p=0.005), NS-SEC (OR=2.94; 95% CI 1.76-4.91) and equivalised household income (lowest versus highest quintile; OR=2.58 (95% CI 1.46-4.57, p=0.001).

Conclusions: This study demonstrated significant associations between pain and socio-economic disadvantage. Apart from the direct impact upon the individual, this clearly has wider societal implications in terms of additional health and social care costs for affected people.