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

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.

Gender differences in the quantitative and qualitative assessment of chronic pain among older people

“…However, there is limited research exploring gender differences in the language used to report pain, considering gender in its biological, psychological, and social dimensions ( 2 , 6 , 8 – 10 ). Women experience pain more often than men ( 11 – 14 ). Studies show a gender difference in the feeling and perception of pain, which increases with age ( 4 , 14 , 15 ).…”

“…Women experience pain more often than men ( 11 – 14 ). Studies show a gender difference in the feeling and perception of pain, which increases with age ( 4 , 14 , 15 ). Women have a lower pain threshold (i.e., the level of perception of a painful stimulus) ( 13 , 16 , 17 ) and tolerance (i.e., the greatest level of pain a person can tolerate) ( 13 , 15 , 16 ), they experience it in more locations ( 13 ), with greater frequency and for longer than men ( 13 , 18 ).…”