Abstract
BackgroundPrevious studies suggest that immigration may influence the experience of pain.ObjectiveThis population-based study examines whether immigration status is associated with chronic pain (CP), chronic widespread pain (CWSP), and severe CP at a two-year follow-up. We also tested mediation by mood status (i.e., anxiety and depression).Methods15, 563 participants from a representative stratified random sample of 34,000 individuals living in south-eastern Sweden completed a postal survey, during 2013–2015, that included the following data: immigration status; presence of CP (pain lasting at least 3 months) and CWSP (a modified classification of widespread pain for use in epidemiological studies); severity of CP based on a numeric rating scale; and depression, anxiety, economic situation, and sociodemographic information. We applied logistic regressions using the generalized estimating equations (GEE), with Swedish-born as the reference group and path analyses models.ResultsCompared to the Swedish-born participants (n = 14,093;90%), the immigrants (n = 1470;10%) had an elevated risk of all pain outcomes (CP: odds ratio [OR] = 1.18; 95% confidence interval [CI = 1.04–1.33, CWSP: OR = 1.39; 95% CI: 1.15–1.69 and severe CP: 1.51; 95% CI: 1.23–1.87) after adjustments. Path analyses showed that baseline age, immigrant status, and financial hardship had a significant influence on chronic pain outcomes at follow-up with baseline mood status as the mediator. Immigration status was also associated with age and financial hardship.ConclusionImmigrants may have increased risk of chronic pain, widespread pain, and severe pain and this risk is mediated by mood status. Targeted interventions better tailored to the socio-economic and psychological status of immigrants with chronic pain are warranted.
Highlights
Previous studies suggest that immigration may influence the experience of pain
Immigrants may have increased risk of chronic pain, widespread pain, and severe pain and this risk is mediated by mood status
We explored whether the relationship between immigrant status and chronic pain is mediated by mood status via a path analysis approach
Summary
Previous studies suggest that immigration may influence the experience of pain. Immigration is considered to be a major determinant in health disparities [1, 2]. Several studies have demonstrated an association between immigration and mental well-being [3,4,5,6,7]. The prevalence of posttraumatic stress disorders and depression is high among immigrants [3, 7]. Previous research using longitudinal data has shown that immigrants are generally at higher risk of poor health [8] (e.g., ischaemic heart disease, diabetes, and stroke) [9,10,11]. Being an immigrant has been associated with a number of psychosocial issues such as economic stress, difficulties in adaptation, increased ambiguity for the future, changes in living conditions and in personal ties, and disruptions of usual social roles and networks [12,13,14,15]
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