Back Pain

24 February 2017

Chronic pain more prevalent among disadvantaged

A study found that people with lower levels of education and wealth don't just have more pain, they also have more severe pain.


Most of us know that poverty can affect our health. Poor people for example often don't have access to clean water, which can lead to diseases like cholera.

Now research has suggested that even pain is more prevalent among the poor. In fact, chronic pain is much more common among poor, less educated older people than their wealthier, more educated peers.

One example of chronic pain is chronic backache. It can seriously affect one's quality of life and even be fatal. Research has shown that there is a link between chronic pain and suicide and depression.

A broken economy

According to a Fin24 article, quoting global aid and development charity Oxfam, inequality between rich and poor is particularly pronounced in South Africa, as the richest 1% of the country's population has 42% ($272bn/R3.7tr) of the total wealth of $650bn. 

The wealth of the richest 10% accounted for 31% of total wealth, or $202bn (R2.8tr), according to Oxfam.

The remaining 90% of the population only account for $175.5bn (R2.4tr) of the country’s wealth.

“Such inequality is the sign of a broken economy, from global to local, and lack of will from government to change the status quo,” said Oxfam SA Executive Director Sipho Mthathi.

Difference across socioeconomic groups

"I found that people with lower levels of education and wealth don't just have more pain, they also have more severe pain," said study author Hanna Grol-Prokopczyk. She's an assistant professor of sociology from the University at Buffalo in Buffalo, New York.

"I also looked at pain-related disability, meaning that pain is interfering with the ability to do normal work or household activities. And again, people with less wealth and education are more likely to experience this disability," she added in a university news release.

In the analysis of 12 years of data from more than 19,000 people aged 51 and older, those with the least education were 80 percent more likely to have chronic pain than those with the most education.

People who didn't finish high school were 370 percent more likely to have severe chronic pain than those with graduate degrees, the study found.

"If you're looking at all pain – mild, moderate and severe combined – you do see a difference across socioeconomic groups," Grol-Prokopczyk said.

According to a Health24 article, poverty is one of the strongest predictors of illness and early death worldwide, and can take two years off your life.

Pressure to reduce opioid prescriptions

"But if you look at the most severe pain, which happens to be the pain most associated with disability and death, then the socioeconomically disadvantaged are much, much more likely to experience it," she said.

Grol-Prokopczyk said further research is needed to learn why chronic pain is much more common among poor and less educated older Americans. The findings are also important when discussing the opioid painkiller abuse epidemic in the United States, she added.

"There are a lot of pressures right now to reduce opioid prescription. In part, this study should be a reminder that many people are legitimately suffering from pain. Health care providers shouldn't assume that someone who shows up in their office complaining of pain is just trying to get an opioid prescription," Grol-Prokopczyk said.

The study, which was published recently in the journal Pain, also highlights the need for research on new treatments.

"We don't have particularly good treatments for chronic pain," Grol-Prokopczyk said. "If opioids are to some extent being taken off the table, it becomes even more important to find other ways of addressing this big public health problem."

Read more:

Pain management

Pain Centre

Chronic pain


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Susan qualified as a Physiotherapist in 1990, and completed her master’s degree in Physiotherapy in 2013 at the University of Pretoria. She has a special interest in human biomechanics, as well as the interaction between domestic and work-related ergonomics.

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