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Disadvantaged Americans are suffering the brunt of rising pain and physical limitations

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  • Dana A Glei
  • Maxine Weinstein

Abstract

Using data from three national surveys of US adults (one cohort and two cross-sectional studies, covering the period from the mid-1990s to the mid-2010s), we quantify the degree to which disparities by socioeconomic status (SES) in self-reported pain and physical limitations widened and explore whether they widened more in midlife than in later life. Unlike most prior studies that use proxy measures of SES (e.g., education), we use a multidimensional measure of SES that enables us to evaluate changes over time in each outcome for fixed percentiles of the population, thereby avoiding the problem of lagged selection bias. Results across multiple datasets demonstrate that socioeconomic disparities in pain and physical limitations consistently widened since the late 1990s, and if anything, widened even more in midlife than in late life (above 75). For those aged 50–74, the SES disparities in most outcomes widened by more than 50% and in some cases, the SES gap more than doubled. In contrast, the magnitude of SES widening was much smaller above age 75 and, in the vast majority of cases, not significant. Pain prevalence increased at all levels of SES, but disadvantaged Americans suffered the largest increases. Physical function deteriorated for those with low SES, but there was little change and perhaps improvement among the most advantaged Americans. At the 10th percentile of SES, the predicted percentage with a physical limitation at age 50 increased by 6-10 points between the late-1990s and the 2010s, whereas at the 90th percentile of SES, there was no change in two surveys and in the third survey, the corresponding percentage declined from 31% in 1996–99 to 22% in 2016–18. The worst-off Americans are being left behind in a sea of pain and physical infirmity, which may have dire consequences for their quality of life and for society as a whole (e.g., lost productivity, public costs).

Suggested Citation

  • Dana A Glei & Maxine Weinstein, 2021. "Disadvantaged Americans are suffering the brunt of rising pain and physical limitations," PLOS ONE, Public Library of Science, vol. 16(12), pages 1-18, December.
  • Handle: RePEc:plo:pone00:0261375
    DOI: 10.1371/journal.pone.0261375
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    References listed on IDEAS

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    1. Glei, Dana A. & Stokes, Andrew & Weinstein, Maxine, 2020. "Changes in mental health, pain, and drug misuse since the mid-1990s: Is there a link?," Social Science & Medicine, Elsevier, vol. 246(C).
    2. David M. Cutler & Ellen Meara & Susan Stewart, 2020. "Socioeconomic Status and the Experience of Pain: An Example from Knees," NBER Working Papers 27974, National Bureau of Economic Research, Inc.
    3. Seeman, T.E. & Merkin, S.S. & Crimmins, E.M. & Karlamangla, A.S., 2010. "Disability trends among older Americans: National Health and Nutrition Examination surveys, 1988-1994 and 1999-2004," American Journal of Public Health, American Public Health Association, vol. 100(1), pages 100-107.
    4. Oakes, J. Michael & Rossi, Peter H., 2003. "The measurement of SES in health research: current practice and steps toward a new approach," Social Science & Medicine, Elsevier, vol. 56(4), pages 769-784, February.
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    1. Glei, Dana A. & Weinstein, Maxine, 2023. "Economic distress, obesity, and the rise in pain," Social Science & Medicine, Elsevier, vol. 339(C).

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