Socioeconomic disparities in pain: The role of economic hardship and daily financial worry.

Abstract

OBJECTIVE: Socioeconomic disparities in pain may be attributable to both greater frequency in stressful financial events as well as greater vulnerability to economic hardship for those at the lower end of the socioeconomic spectrum. This study investigated the effects of economic hardship and daily financial worry on daily pain among women with a chronic musculoskeletal condition. DESIGN: The sample consisted of 250 women with osteoarthritis (N = 105), fibromyalgia (N = 46), or both (N = 99). During an initial assessment, participants' chronic pain diagnosis, level of economic hardship, and demographic information were ascertained. For a period of 30 days, daily diary assessments recorded daily financial worries and daily pain severity. Hypotheses were tested using multilevel modeling for repeated measures in SAS PROC MIXED. MAIN OUTCOME MEASURE: Daily pain severity. RESULTS: Conditions of economic hardship and daily ratings of financial worry both had significant detrimental effects on daily pain. Participants with greater levels of economic hardship reported greater pain severity in response to daily financial worries than their counterparts with little or no economic hardship. Further, participants in the sample who were not employed and who reported higher levels of economic hardship exhibited the most pain reactivity in response to daily financial worries. CONCLUSION: Economic hardship was associated not only with greater exposure to daily financial worries but also with greater vulnerability to pain on days when daily financial worries were experienced.