PainRelief.com Interview with:
Hanna Grol-Prokopczyk PhD
Department of Sociology
University at Buffalo, SUNY
PainRelief.com: What is the background for this study?
Response: Although chronic pain is recognized as an extremely common and costly health problem, little research has explored temporal trends in pain prevalence. Indeed, as recently as 5-6 years ago, there was no published research using general population data examining whether pain prevalence in the U.S. was going up, going down, or staying constant. (This can be contrasted to conditions such as diabetes and cancer, for which information about long-term trends is readily available. Of note, chronic pain affects more Americans than diabetes, cancer, and heart disease combined.) In recent years, a few studies have documented rising pain prevalence in the U.S., but most have used data on middle-aged or older adults.
PainRelief.com: What are the main findings?
Response: Our study is the first to examine U.S. pain trends and their correlates across a very broad age range: 25 to 84. Using annual, repeat cross-sectional data from the National Health Interview Survey (N = 441,707), we found that U.S. adult pain prevalence increased by about 10% over the study period (2002-2018). Moreover, the increase in pain prevalence was found in every age group (not just among the middle-aged or older), as well as in every demographic group, whether defined by sex, race/ethnicity, education level, income level, etc. The increase was also seen for every site of pain that our dataset asked about: joint pain, back pain, neck pain, headache/migraine, and facial/jaw pain. The increase in pain prevalence was particularly steep among men, Black individuals, and individuals with lower levels of education or income. To be clear, our findings are not simply a reflection of population aging: our models adjust for age, so our findings tell us that even at the exact same age, a person in 2018 was more likely to have pain than a person in 2002.
We also examined factors that tracked most closely with the increase in pain. These included physical health conditions such as obesity and diabetes, health behaviors such as alcohol use, and mental health factors such as psychological distress.
PainRelief.com: What should readers take away from your report?
Response: A key take-away of this study is that levels of chronic pain, already very high at baseline, have been steadily getting higher for about two decades. This is the case for every age group and demographic subgroup. Moreover, our findings regarding correlates of chronic pain highlight that it tracks not only with other physical health problems and health behaviors, but with psychological factors. To be fully understood, chronic pain must thus be addressed as a reflect of both physical and mental health.
PainRelief.com: What recommendations do you have for future research as a result of this work?
Response: It is increasingly clear that chronic pain must be considered a very serious public health problem. Future research could further explore the mechanisms underlying the increase in pain—something our study could do only tentatively, due to reliance on repeat cross-sectional rather than longitudinal data. In addition, it is important to examine not only immediate factors contributing to individuals’ pain, but also “upstream” factors that contribute to psychological distress, obesity, and other health problems among Americans, since these seem to be closely linked with the increase in pain.
PainRelief.com: Is there anything else you would like to add?
Response: Research reported in this study was supported by the National Institute on Aging of the National Institutes of Health under award number R01AG06535101 (PI: Hanna Grol-Prokopczyk) and by the Social Sciences and Humanities Research Council of Canada via the Canada Research Chairs program (Zachary Zimmer).
Anna Zajacova, Hanna Grol-Prokopczyk, Zachary Zimmer; Pain Trends Among American Adults, 2002–2018: Patterns, Disparities, and Correlates. Demography 1 April 2021; 58 (2): 711–738. doi: https://doi.org/10.1215/00703370-8977691
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