Highlights
- •Youth with chronic pain have lower family income and more barriers to health care.
- •They have also experienced more violence and more safety concerns.
- •More health care barriers increase risk for pain and may exacerbate disparities.
- •Safety concerns among youth with chronic pain lead to worse mental health.
- •Research is needed on the pain experiences of youth from diverse backgrounds.
Abstract
Research in adult populations indicates that several sociodemographic and environmental
variables increase risk for pain and poor outcomes. There is little research exploring
the impact of household income, health insurance coverage, barriers to health care,
neighborhood and school safety, violence experienced, and neighborhood isolation on
pediatric chronic pain. Data from the Add Health Study, a longitudinal examination
of a nationally-representative adolescent sample were analyzed. The relationships
between demographic variables, risk factors, chronic pain, and long-term health outcomes
were examined. Adolescents with chronic pain had lower income, more health care barriers,
greater safety concerns, and experienced more violence compared to those without pain.
In a model together, female sex, White race/ethnicity, and greater health care barriers,
safety concerns, and violence exposure conferred significant risk for chronic pain.
Additional analyses revealed nuances in the strength of risk factors between racial/ethnic
groups. Systemic health care barriers were significantly associated with chronic pain
and may delay symptom alleviation and return to functioning. Considering access to
care is necessary in prevention efforts. Among adolescents with chronic pain, greater
safety concerns predicted poor mental health outcomes, particularly for White females.
The cumulative stress of environmental concerns, such as safety, and managing chronic
pain may worsen functioning.
Perspective
Adolescents with chronic pain had lower income, and more health care barriers, safety
concerns, and violence exposure compared to those without chronic pain. Access to
care is a significant problem in youth with chronic pain. The relationships between
race/ethnicity, risk factors, and health outcomes are complex and require additional
research.
Key words
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Article info
Publication history
Published online: June 27, 2019
Accepted:
June 10,
2019
Received in revised form:
May 31,
2019
Received:
February 28,
2019
Footnotes
Disclosures: No funding sources were provided for this research. The authors have no conflicts of interest to declare.
Identification
Copyright
© 2019 by United States Association for the Study of Pain, Inc.
