JMIR Publications

ABSTRACT

Background:

Fewer studies focus on the equality of pain, and the relationship between pain and death is inconclusive. Investigating the distribution of pain and potential mortality risks is crucial for ameliorating painful conditions and devising targeted intervention measures.

Objective:

Our study aimed to investigate the association between inequalities in pain and all-cause mortality in China.

Methods:

Longitudinal cohort data from the China Health and Retirement Longitudinal Study (CHARLS) 2011-2013 (waves 1, wave 2) were used in this study. Pain was self-reported at baseline, and death information was obtained from the 2013 follow-up survey. The concentration index and its decomposition were used to explain the inequity of pain, and the association between pain and death was analyzed by cox proportional risk model.

Results:

A total of 16747 participants were included, with an average age of 59.57±9.82 years old. The prevalence of pain was 32.54% (8196/16747). The main pain type was moderate pain (36.36%), and the common pain locations were waist (19.30%), leg (14.78%), and head (13.44%). We found that the prevalence of pain was concentrated in participant with poor economic status (concentration index: -0.066, 95%CI: -0.078, -0.054), and educational level (36.49%), location (36.87%) and economic status (25.05%) contributed significantly to the inequality of pain. In addition, cox regression found that participants with pain was associated with an increased risk of all-cause mortality (HR=1.30, 95%CI: 1.06, 1.61).

Conclusions:

The prevalence of pain in Chinese adults is concentrated among participants with poor economic conditions, and pain increases the risk of all-cause death. Our results highlight the importance of socioeconomic factors to reduce deaths due to pain inequities by implementing targeted interventions to reduce pain inequities.