The relationship between self-reported severe pain and measures of socio-economic disadvantage

Aims: To determine the association of severe pain with socioeconomic characteristics. Methods: Data was extracted from the Health Survey for England (HSE), 2005. The HSE is a series of annual cross-sectional surveys designed to describe the health of people living in private homes in England, from a random sample of 720 postcode sectors. Interviewees were P16 years. Pain severity was characterised by the EQ-5D. Socioeconomic status was classified by ability to work, social security benefits, the National Statistics Socio-economic Classification (NS-SEC) and the Index of Multiple Deprivation (IMD). Results: Pain status was recorded for 9419 subjects of whom 431 (4.6%) reported severe pain. 156 of those reporting severe pain were of working age. Of these 68 (43.6%) stated they were unable to work due to sickness or disability and 64 (41.0%) claimed a state benefit. After adjusting for disease and demographic variables, severe pain was associated with the IMD with an odds ratio of 1.65 (95% CI 1.16-2.34, p = 0.005), NS-SEC (OR = 2.94; 95% CI 1.76-4.91) and equivalised household income (lowest versus highest quintile; OR = 2.58 (95% CI 1.46-4.57, p = 0.001). Conclusions: This study demonstrated significant associations between pain and socio-economic disadvantage. Apart from the direct impact upon the individual, this clearly has wider societal implications in terms of additional health and social care costs for affected people. (C) 2011 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.