A Comparison of Chronic Pain Between an Urban and Rural Population

Abstract

Residents of rural and urban areas of North Dakota were surveyed regarding chronic pain. Participants (N = 188) responded to questions pertaining to the prevalence and characteristics of chronic pain, quality of life, and social support. Overall, 58% of the participants reported chronic pain, with arthritis as the leading cause, the lower back as the main location, and oral medication as the most common treatment. Individuals from rural and urban locations differed significantly in the rate of chronic pain reported. Participants with chronic pain reported a significantly lower quality of life than individuals without chronic pain.

The epidemiology of regional and widespread musculoskeletal pain in rural versus urban settings in those ≥55 years

“…5 Some authors have described elevated levels of chronic pain in a rural Swedish population 6 and in a rural area of the United States, compared to an urban area. 4 However, there were no significant differences in prevalence between individual pain sites. Others have demonstrated a high pain prevalence in a Canadian sample that included a disproportionately high number of rural participants.…”

“…1 The majority of epidemiological studies of pain have considered urban or sub-urban populations with few studies in communities that are rural (small population size) or remote (distant from large towns). 4 Although definitions vary, the Scottish Government defines 'accessible rural' areas as those with fewer than 3000 people and within 30 minutes drive of a settlement of 10,000 or more and 'remote rural' areas as settlements of <3000 people and with a drive time of >30 minutes to a settlement of 10,000 or more. 5 Some authors have described elevated levels of chronic pain in a rural Swedish population 6 and in a rural area of the United States, compared to an urban area.…”

“…Others have demonstrated a high pain prevalence in a Canadian sample that included a disproportionately high number of rural participants. 7 However, work in this area is limited: sample sizes and response rates are low, 4,7 and although samples are described as rural, it is not always clear how this is actually defined. 6 The essential difference between rural and urban populations, in terms of health care, is the relative accessibility of services, but there may also be differences with regard to aetiology.…”

“…[1][2][3]8,9 While there are no real reasons to believe that a different set of risk factors will be important in rural areas, the relative importance of risk factors may differ. For example, studies have found that in those with chronic pain, higher quality of life is related to lower social constraints, suggesting benefits of strong social support networks, 4 and it may be that these are easier to maintain in urban rather than rural communities. Also, generally speaking, rural populations are older, have higher levels of manual labour (and individuals remain in physical occupations later in life 10 ) and higher levels of social isolation, with the dispersal of social groupings leading to distinct social interaction effects.…”

Technology for Older Adults: Maximising Personal and Social Interaction: Exploring Opportunities for eHealth to Support the Older Rural Population with Chronic Pain

“…The prevalence increases with age. It affects physical and psychological health, is associated with increased social isolation (Clarke & Iphofen 2008) and the incidence is reportedly higher in rural than urban areas (Hoffman et al 2002;Day & Thorn 2010;Reitsma et al 2012). Specialist pain services and patient self-help group meetings tend to be physically located in urban centres, presenting access challenges to rural patients.…”