Pain Lowers Subjective Survival Probabilities among Middle-aged and Older Adults.

Abstract

Pain is a leading cause of disability and a limiting factor in individuals' assessments of their own subjective health, however its association with subjective longevity has yet to be explored. Subjective survival probabilities (SSPs), or one's own perceived chances of living to a given age, can influence individuals' behavior as they plan for their futures. This study assesses whether pain correlates to lower SSPs. We use a repeated cross-section of the 2000-2018 waves of the Health and Retirement Study, a longitudinal and nationally representative survey of Americans aged 51 and older (N=31,773). Fractional logit regressions indicate that, across all age groups, respondents with severe and/or interfering pain reported significantly lower SSPs than those with no pain (Marginal Effect (ME) = -0.03 to -0.06, p < .05). Controlling for all covariates, mild or moderate non-interfering pain was only associated with a significant reduction in SSPs among the youngest group reporting their chances of living to age 75 (ME = -0.02, p < .001). Descriptively and in the model results, respondents with mild or moderate non-interfering pain appeared to more closely resemble pain-free respondents than those with severe or interfering pain. These findings highlight the importance of pain on SSPs, and contribute to the growing evidence that pain interference is uniquely important in predicting meaningful health outcomes.