Discrimination hurts: The effect of discrimination on the development of chronic pain

Soc Sci Med. 2018 May;204:1-8. doi: 10.1016/j.socscimed.2018.03.015. Epub 2018 Mar 8.


We examine the hypothesis that psychological distress due to perceived discrimination can result in chronic pain, where perceived discrimination is based on age, gender, race, ethnicity, disability, sexual orientation, height/weight, religion, and other characteristics. Using a sample of 1908 individuals from the two most recent waves (2004-2006 and 2013-2014) of panel data from the National Survey of Midlife Development in the United States, we apply instrumental variables regression where measures of daily and lifetime perceived discrimination are instruments whose effects on chronic pain are mediated by psychological distress. We find statistically significant dose-response relationships between daily perceived discrimination and psychological distress, between lifetime perceived discrimination and psychological distress, and between psychological distress and chronic pain. Based on our instrumental variables regression model, we estimate that 4.1 million people in the US in 2016, aged 40 and older, experience chronic pain that is caused by increased psychological distress, where psychological stress has increased due to perceived discrimination.

Keywords: Chronic pain; Discrimination; Instrumental variables; Psychological distress.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Pain / etiology*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prejudice / psychology*
  • Regression Analysis
  • Stress, Psychological / complications*
  • Stress, Psychological / etiology
  • United States