Chronic Pain and Friendship Among Middle-Aged and Older U.S. Adults[A longitudinal study of the impact of physical and cognitive decline on the personal network in old age]

ObjectivesThis study examines how chronic pain affects friendship in later life. We test whether onset of pain leads to social network activation, as suggested by research on other health conditions, or whether pain—an unverifiable and often stigmatizing condition—functions as a “threat to the social self”.MethodUsing longitudinal data from the Health and Retirement Study (HRS; N = 4,598; 2006/2008 as Time 1 and 2010/2012 as Time 2), we conducted OLS regressions with a lagged dependent variable approach to assess how new-onset chronic pain predicted (a) respondents’ number of close friends and (b) their frequency of in-person meetings with friends, controlling for sociodemographic variables and health conditions.ResultsNew-onset severe pain predicted a decrease in number of friends. New-onset moderate pain, in contrast, predicted more friends and more frequent in-person meetings. (Findings were significant or marginally significant depending on model specifications.) Mild pain showed no significant association with either outcome. Pain had a greater effect on men’s friendship outcomes than women’s.DiscussionThe effects of chronic pain on later-life friendships appear to depend on pain severity, and to differ between men and women. Onset of severe pain serves as a “threat to the social self,” while onset of moderate pain contributes to social network activation; both associations are significantly more pronounced among men. These findings highlight the complex associations between health and social outcomes.