Associations of socioeconomic position and pain prevalence in the United States: findings from the National Health and Nutrition Examination Survey

Pain Med. 2014 Sep;15(9):1508-21. doi: 10.1111/pme.12528. Epub 2014 Aug 19.


Background: Pain is a significant burden within the U.S. adult population, but little is known regarding epidemiology of pain, particularly with respect to race, ethnicity, and socioeconomic position (SEP).

Objective: The purpose of this study was to describe and evaluate prevalence and distribution of pain in the United States.

Methods: With data from the population-based 2003-2004 National Health and Nutrition Examination Survey, prevalence of acute (<3 months) and chronic (≥ 3 months) pain was evaluated, including subgroup analyses of race, ethnicity, and SEP, with SEP defined by the poverty-to-income ratio, a ratio derived from the federal poverty level, accounting for household income and number of household members.

Results: Prevalence of acute pain was 12.2% (95% confidence interval: 11.2-13.3%). Non-Hispanic black as well as Hispanic and Mexican-American individuals had higher rates of acute pain than non-Hispanic white people, and a higher prevalence was noted in those with higher SEP. Chronic pain prevalence was 15.6% (13.4-17.7%), with non-Hispanic white people having a higher prevalence than those in other racial and ethnic groups.

Conclusion: Trends of chronic pain by SEP were opposite of acute pain as those in the highest SEP group tended to have less chronic pain than those in lower SEP groups. These findings suggest that SEP, in addition to race and ethnicity, may play a role in the development of pain as well as its treatment and management.

Keywords: Health Disparities; Health Surveys; Prevalence; Regional Pain; Socioeconomic Status.

MeSH terms

  • Acute Pain / epidemiology
  • Aged
  • Alcohol Drinking / epidemiology
  • Chronic Pain / epidemiology
  • Comorbidity
  • Continental Population Groups / statistics & numerical data
  • Cross-Sectional Studies
  • Employment
  • Ethnic Groups / statistics & numerical data
  • Female
  • Health Status Disparities
  • Humans
  • Income
  • Insurance Coverage
  • Male
  • Middle Aged
  • Motor Activity
  • Nutrition Surveys
  • Overweight / epidemiology
  • Pain / epidemiology*
  • Prevalence
  • Smoking / epidemiology
  • Social Class*
  • United States / epidemiology