Pain is a major health problem among US adults. Surprisingly little, however, is known about educational disparities in pain, especially among the nonelderly. In this study, we analyze disparities in pain across levels of educational attainment. Using data from the 2010-2017 National Health Interview Survey among adults aged 30-49 (N=74,051), we estimate logistic regression models of pain prevalence using a dichotomous summary pain index and its five constituent pain sites (low back, joint, neck, headache/migraine, and facial/jaw). We find a significant and steep pain gradient: greater levels of educational attainment are associated with less pain, with two important exceptions. First, adults with a high-school equivalency diploma (GED) and those with ‘some college’ have significantly higher pain levels than high school graduates despite having an equivalent or higher attainment, respectively. Second, the education-pain gradient is absent for Hispanic adults. After taking into account important covariates including employment, economic resources, health behaviors, physical health conditions, and psychological wellbeing, educational disparities in pain are no longer statistically significant except for the GED and ‘some college’ categories, which still show significantly higher pain levels than high school graduates. We thus document the overall education-pain gradient in most younger US adult populations, and identify groups where pain is higher than expected (certain educational categories) or lower than expected (e.g., less-educated Hispanics). Understanding the causes of these anomalous findings could clarify factors shaping pain prevalence and disparities therein. PERSPECTIVE Over 50% of US adults age 30-49 report pain. Overall, more educated Americans report substantially less pain than the less educated. However, adults with a GED and ‘some college’ report more pain than other groups. Understanding the causes could help illuminate the mechanisms through which social factors influence pain.
Copyright © 2020. Published by Elsevier Inc.