Socioeconomic and sex inequalities in chronic pain: A population-based cross-sectional study

PLoS One. 2023 May 25;18(5):e0285975. doi: 10.1371/journal.pone.0285975. eCollection 2023.

Abstract

Objective: We investigated the impact of socioeconomic inequalities on chronic pain of older adults according to sex.

Materials and methods: This population-based cross-sectional study used survey data from the 2015 cohort of the SABE Study (Saúde, Bem-estar e Envelhecimento), Brazil. Socioeconomic status was examined at individual level (educational attainment, financial independence, and race/skin color) and contextual level (Human Development Index). We analyzed the association between variables using the chi-square test and the Rao & Scott correction. Logistic regression models were adjusted for risk factors.

Results: The study comprised 1,207 older adults representing 1,365,514 residents 60≥ years of age in the city of São Paulo. Chronic pain was more frequent in females (27.2%) than in males (14.5%) (p<0.001). Females evidenced the worst self-perception of pain, especially those of the most vulnerable socioeconomic strata. Social inequalities impacted chronic pain in different ways between sexes. Among females, unfavorable living conditions (OR = 1.59; 95%CI 1.07; 2,37) and Blacks/Browns females were most likely to have chronic pain (OR = 1.32; 95%CI 1.01; 1.74). Among males, only the individual aspects were significant for the occurrence of chronic pain, such as low educational attainment (OR = 1.88; 95%CI 1.16; 3.04) and insufficient income (OR = 1.63; 95%CI 1.01; 2.62).

Discussion: The potential for inequality was greater for females than for males reflecting structural factors inherent in a highly unequal society. Conclusions: Equity-oriented health policies are critical to preventing pain in human aging.

MeSH terms

  • Aged
  • Brazil / epidemiology
  • Chronic Pain* / epidemiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Social Class
  • Socioeconomic Factors

Grants and funding

The author(s) received no specific funding for this work.