Examining chronic pain through the lens of the socioeconomic gradient

Abstract

Longstanding evidence reveals the existence of a gradient of health running along the socioeconomic spectrum. This is denoted by a graded association between health and levels of socioeconomic status, including factors such as gender, income, education, and occupational roles. This gradient is found across many chronic diseases including heart failure, arthritis, type 2 diabetes, ulcers, and certain cancers, all of which commonly possess debilitating pain diagnoses. Here, I examine chronic pain and its severity through the lens of this socioeconomic gradient across three perspectives along with their potential limitations. First, I discuss how this gradient represents risk factors for greater pain severity, disability, and comorbidity. Then, I explore potential underlying health determinants and how one’s position on this spectrum may predetermine their chance of receiving optimal care for their pain. Finally, I end with the prospect of better clinical and biological understanding of chronic pain severity with the inclusion of this socioeconomic gradient.