Why is pain more common amongst people living in areas of low socio-economic status? A population-based cross-sectional study

Abstract

Study objective To confirm a relationship between self-reported oro-facial pain and deprivation using an area-based measure of deprivation, and to investigate possible mechanisms of the association. Design A cross sectional population based survey. Setting General medical practice in South-East Cheshire (Borough of Congleton, North West England). Participants Two thousand, five hundred and four people aged 18-65 years living in the community. Methods A postal questionnaire was sent which asked about pain in the oro-facial region. Information on factors which may 'explain' any relationship between pain and social class was collected: psychological distress, maladaptive responses to illness, sleep problems and local mechanical factors such as teeth grinding and facial trauma. Participants were allocated a Townsend index deprivation score on the basis of their postcode. Main results The study achieved an adjusted participation rate of 74% (N = 2,504) and the overall prevalence of oro-facial pain was 26%. Statistical analysis revealed that people in the most deprived areas were more likely to report oro-facial pain compared with the most affluent ones [OR 1.50 (95% confidence interval 1.09, 2.07)]. This relationship remained after adjusting for all potential confounding factors. Conclusion While the relationship between oro-facial pain and deprivation exists, the mechanisms of such relationships are not clear. Local mechanical factors, trauma or psychological distress did not explain it. The factors linking pain with social deprivation remain to be elucidated.

Prevalence of Various Orofacial Pain Symptoms and Their Overall Impact on Quality of Life in a Tertiary Care Hospital in India

“…The prevalence of orofacial pain symptoms was found to be 42.7 % in the present study among the patients reporting to the OPD of the Government Dental college which was found to be similar to the study done by Chung et al [4] (42 %), Allen et al [16] (41.6 %) and Locker and Grushka [17] (39.7 %) but the prevalence of orofacial pain symptoms was reported to be lower in the study by Riley et al [18] (17.4 %), Macfarlane et al [7] (26 %) and Aggarwal et al [19] (26 %). The higher prevalence in the present study might be related to the reduced dental awareness and reduced access to dental care among the Indian population because of the socio-cultural differences between the study population and the other populations used for comparison.…”

Dental pain and associated factors in 2 to 4-year-old children in Goiânia

“…The great majority of studies published about dental pain in childhood and adolescence in Brazil shows the effect of one or more socioeconomic factors 4,[6][7][8][9]12,13 . The relation between economic deprivation and pain was also found with regard to the orofacial pain 20 . An explanation for this finding may be more exposure of the less privileged people to risk factors for oral health problems.…”

The pain of low status: the relationship between subjective socio-economic status and analgesic prescriptions in a Scottish community sample

“…Since participants' GP surgeries-and therefore participants themselves-were located in areas with varying neighbourhood SES levels; which affects health; e.g., Chen & Paterson, 2006, and pain specifically; Fuentes, Hart-Johnson, & Green, 2007;Aggarwal, Macfarlane, & Macfarlane, 2003; we created a categorical variable to indicate the GP surgery the participant attended. Three surgeries were in the same location, so we combined these into one category (Location 2).…”