Life course socioeconomic status, chronic pain, and the mediating role of allostatic load: findings from the midlife in the United States
Low socioeconomic status (SES) has been linked to chronic pain (CP); however, the mechanisms by which SES over the life course influences downstream CP outcomes remain unclear. This study utilizes data from the Midlife in the United States (MIDUS) survey, a prospective sample of community-dwelling i...
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| Veröffentlicht in: | Frontiers in public health Jg. 12; S. 1365105 |
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| Abstract | Low socioeconomic status (SES) has been linked to chronic pain (CP); however, the mechanisms by which SES over the life course influences downstream CP outcomes remain unclear.
This study utilizes data from the Midlife in the United States (MIDUS) survey, a prospective sample of community-dwelling individuals (
=781), to investigate the chain of risk additive model of SES in relation to CP. Additionally, the study examines the mediating role of allostatic load (AL) in the relationship between life course SES and CP. Confirmatory factor analysis was employed to capture the multidimensionality of life course SES and path analysis was used to examine the direct and indirect effects on CP. AL was computed by quartile-based summation and by latent class analysis.
Results indicated lower SES in MIDUS 2 was associated with greater high-interference CP odds in MIDUS 3 (OR=1.069, 95% CI=1.006-1.136,
< 0.05) and no association was found between distal SES and levels of CP interference. Similarly, no significant relationship was observed between SES and the number of CP locations. Additionally, no additive effects of SES were found, and AL did not present mediation effects on the association between life course SES and CP.
The present study emphasizes the importance of directly proximal effects of SES on CP, underscoring the need for equitable distribution of health resources and the implementation of policies focused on diminishing socioeconomic inequalities. Further research is needed to examine alternative pathways by which proximal SES impact CP. |
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| AbstractList | Low socioeconomic status (SES) has been linked to chronic pain (CP); however, the mechanisms by which SES over the life course influences downstream CP outcomes remain unclear.
This study utilizes data from the Midlife in the United States (MIDUS) survey, a prospective sample of community-dwelling individuals (
=781), to investigate the chain of risk additive model of SES in relation to CP. Additionally, the study examines the mediating role of allostatic load (AL) in the relationship between life course SES and CP. Confirmatory factor analysis was employed to capture the multidimensionality of life course SES and path analysis was used to examine the direct and indirect effects on CP. AL was computed by quartile-based summation and by latent class analysis.
Results indicated lower SES in MIDUS 2 was associated with greater high-interference CP odds in MIDUS 3 (OR=1.069, 95% CI=1.006-1.136,
< 0.05) and no association was found between distal SES and levels of CP interference. Similarly, no significant relationship was observed between SES and the number of CP locations. Additionally, no additive effects of SES were found, and AL did not present mediation effects on the association between life course SES and CP.
The present study emphasizes the importance of directly proximal effects of SES on CP, underscoring the need for equitable distribution of health resources and the implementation of policies focused on diminishing socioeconomic inequalities. Further research is needed to examine alternative pathways by which proximal SES impact CP. IntroductionLow socioeconomic status (SES) has been linked to chronic pain (CP); however, the mechanisms by which SES over the life course influences downstream CP outcomes remain unclear.MethodsThis study utilizes data from the Midlife in the United States (MIDUS) survey, a prospective sample of community-dwelling individuals (N=781), to investigate the chain of risk additive model of SES in relation to CP. Additionally, the study examines the mediating role of allostatic load (AL) in the relationship between life course SES and CP. Confirmatory factor analysis was employed to capture the multidimensionality of life course SES and path analysis was used to examine the direct and indirect effects on CP. AL was computed by quartile-based summation and by latent class analysis.ResultsResults indicated lower SES in MIDUS 2 was associated with greater high-interference CP odds in MIDUS 3 (OR=1.069, 95% CI=1.006-1.136, P < 0.05) and no association was found between distal SES and levels of CP interference. Similarly, no significant relationship was observed between SES and the number of CP locations. Additionally, no additive effects of SES were found, and AL did not present mediation effects on the association between life course SES and CP.DiscussionThe present study emphasizes the importance of directly proximal effects of SES on CP, underscoring the need for equitable distribution of health resources and the implementation of policies focused on diminishing socioeconomic inequalities. Further research is needed to examine alternative pathways by which proximal SES impact CP. Low socioeconomic status (SES) has been linked to chronic pain (CP); however, the mechanisms by which SES over the life course influences downstream CP outcomes remain unclear.IntroductionLow socioeconomic status (SES) has been linked to chronic pain (CP); however, the mechanisms by which SES over the life course influences downstream CP outcomes remain unclear.This study utilizes data from the Midlife in the United States (MIDUS) survey, a prospective sample of community-dwelling individuals (N=781), to investigate the chain of risk additive model of SES in relation to CP. Additionally, the study examines the mediating role of allostatic load (AL) in the relationship between life course SES and CP. Confirmatory factor analysis was employed to capture the multidimensionality of life course SES and path analysis was used to examine the direct and indirect effects on CP. AL was computed by quartile-based summation and by latent class analysis.MethodsThis study utilizes data from the Midlife in the United States (MIDUS) survey, a prospective sample of community-dwelling individuals (N=781), to investigate the chain of risk additive model of SES in relation to CP. Additionally, the study examines the mediating role of allostatic load (AL) in the relationship between life course SES and CP. Confirmatory factor analysis was employed to capture the multidimensionality of life course SES and path analysis was used to examine the direct and indirect effects on CP. AL was computed by quartile-based summation and by latent class analysis.Results indicated lower SES in MIDUS 2 was associated with greater high-interference CP odds in MIDUS 3 (OR=1.069, 95% CI=1.006-1.136, P < 0.05) and no association was found between distal SES and levels of CP interference. Similarly, no significant relationship was observed between SES and the number of CP locations. Additionally, no additive effects of SES were found, and AL did not present mediation effects on the association between life course SES and CP.ResultsResults indicated lower SES in MIDUS 2 was associated with greater high-interference CP odds in MIDUS 3 (OR=1.069, 95% CI=1.006-1.136, P < 0.05) and no association was found between distal SES and levels of CP interference. Similarly, no significant relationship was observed between SES and the number of CP locations. Additionally, no additive effects of SES were found, and AL did not present mediation effects on the association between life course SES and CP.The present study emphasizes the importance of directly proximal effects of SES on CP, underscoring the need for equitable distribution of health resources and the implementation of policies focused on diminishing socioeconomic inequalities. Further research is needed to examine alternative pathways by which proximal SES impact CP.DiscussionThe present study emphasizes the importance of directly proximal effects of SES on CP, underscoring the need for equitable distribution of health resources and the implementation of policies focused on diminishing socioeconomic inequalities. Further research is needed to examine alternative pathways by which proximal SES impact CP. |
| Author | Liang, Yunlong |
| AuthorAffiliation | Institute for Social and Economic Research, University of Essex , Colchester , United Kingdom |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38562255$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/j.socscimed.2011.09.037 10.1016/0304-3959(90)91125-3 10.1207/S15328007SEM0803_5 10.1186/1471-2288-11-147 10.1016/S0140-6736(21)00393-7 10.1093/gerona/glab187 10.1016/j.pnpbp.2019.04.006 10.1177/0898264310374355 10.1093/geronb/gby014 10.1093/ije/31.2.285 10.1093/eurpub/cks056 10.1016/j.psyneuen.2016.05.017 10.1093/ije/dyp277 10.1016/j.neubiorev.2009.10.002 10.1177/0095798420930932 10.1097/j.pain.0000000000001384 10.1136/jech-2017-209123 10.1097/j.pain.0000000000000762 10.1007/978-1-908517-43-2_6 10.1016/j.neurobiolaging.2013.07.028 10.1111/j.1749-6632.1999.tb08103.x 10.1136/bmjopen-2018-024250 10.1016/j.jpain.2021.03.139 10.1146/annurev-soc-090320-094912 10.1097/CCM.0000000000004710 10.1093/ije/dyw329 10.1111/j.1749-6632.1998.tb09546.x 10.1177/2470547017704763 10.1097/j.pain.0000000000002634 10.1093/geronb/gbx162 10.1016/j.jpain.2012.04.003 10.1093/geronb/gbt122 10.1002/cphy.c150015 10.1080/10705511.2015.1065414 10.1016/j.neuron.2012.01.001 10.1016/j.exger.2016.12.013 10.1016/j.ssmph.2023.101389 10.1016/j.pmn.2017.11.004 10.1007/978-3-030-06200-2_26 10.1016/j.socscimed.2017.09.025 10.1215/00703370-8977691 10.1016/j.tins.2020.01.002 10.1177/0022146510383498 10.1155/2016/7657329 10.1177/00221465211025962 10.1016/j.alcr.2018.02.002 10.2307/2626958 10.1080/10705519909540118 10.1097/j.pain.0000000000002291 10.1177/0022146512475089 10.1136/jech.2010.108332 10.1037//0003-066x.49.1.15 10.1037/a0022025 10.1007/978-0-387-09834-0 10.1016/j.jpsychores.2022.111050 10.1097/j.pain.0000000000001390 10.1136/ard.2008.093088 |
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| Keywords | midlife adults chain of risk additive model chronic pain allostatic load life course |
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| SubjectTerms | Allostasis allostatic load chain of risk additive model Chronic Pain Humans Life Change Events life course midlife adults Prospective Studies Public Health Social Class United States |
| Title | Life course socioeconomic status, chronic pain, and the mediating role of allostatic load: findings from the midlife in the United States |
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