The association between neighbourhood socio-economic status and the onset of chronic widespread pain: results from the EPIFUND study

Davies, K.A., Silman, A.J., Macfarlane, G.J., Nicholl, B.I. , Dickens, C., Morriss, R., Ray, D. and McBeth, J. (2009) The association between neighbourhood socio-economic status and the onset of chronic widespread pain: results from the EPIFUND study. European Journal of Pain, 13(6), pp. 635-640. (doi:10.1016/j.ejpain.2008.07.003)

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Publisher's URL: http://dx.doi.org/10.1016/j.ejpain.2008.07.003

Abstract

Background Cross-sectional studies have reported an inverse relationship between socio-economic status and the prevalence of chronic widespread pain (CWP). However, the extent to which this relationship is explained by psychological factors is unknown. The aim of this study was to examine the hypothesis that socio-economic status predicts the onset of CWP but that this relationship would be explained by psychological factors.

Methods Subjects from three diverse socio-economic areas were recruited into a population-based prospective survey of pain. Subjects completed a questionnaire at baseline that assessed pain status and psychological factors and occupation. Fifteen months later subjects completed a follow-up questionnaire which assessed pain status.

Results A total of 3489 subjects were free of CWP at baseline and eligible for follow-up, of whom 2782 (79.7%) participated. Of those, 281 (10%) subjects were classified as having new CWP. Logistic regression analysis revealed that compared to subjects from the most affluent socio-economic area, those from the moderate and least affluent areas were respectively, 1.47 (95% CI: 1.08–2.01) and 1.35 (95% CI: 1.00–1.82) times more likely to have new CWP. However, in a stepwise multivariate logistic regression analysis, controlling for psychological factors, the relationship between new onset CWP and socio-economic status was no longer evident.

Conclusions This study has demonstrated that socio-economic status is related to new onset CWP, but the association is explained by psychological factors. Understanding the factors underlying the association between socio-economic status and pain should help to design intervention strategies which may reduce the burden of chronic pain in identified high risk population groups.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Nicholl, Dr Barbara
Authors: Davies, K.A., Silman, A.J., Macfarlane, G.J., Nicholl, B.I., Dickens, C., Morriss, R., Ray, D., and McBeth, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:European Journal of Pain
ISSN:1090-3801
Published Online:09 January 2012

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