Americans with lower education levels suffer more pain than people with more education

Americans with university degrees or higher level of education endure substantially less pain than those who are less educated, according to an international study led by Western University.

With more than half of U.S. adults reporting chronic pain, the study will help health-care professionals and policymakers better target relief, the researchers said.

"Pain affects quality of life of individuals and their families," said Western sociology professor Anna Zajacova. "It is an incredibly important health condition that we must try to understand better. And like many other seemingly personal issues, there are powerful social forces driving pain in society. Education is one of those forces."

Using data from the 2010-2017 U.S. National Health Interview Survey, researchers found that half of Americans aged 30 to 49 report pain in at least one of five key sites in the body—the lower back, joints, neck, face/jaw, or headache/migraine.

But when exploring the educational levels of those hurting, more education did not always mean less pain: One important exception was the strikingly high amounts of pain reported by Americans with an incomplete college education or with a GED (a high-school-equivalency certification for adults who dropped out of high school). A second exception was that Hispanic adults don't have this educational pain "penalty" within the context of this study.

Adults with a GED reported the highest level of pain (61.8 percent), followed by those with some college (56.4 percent), vocational/associate degrees (53.3 percent), high-school dropouts with no credentials (51.5 percent), and high-school graduates (50.9 percent). Adults with a university degree reported considerably lower prevalence of pain (45 percent among BA recipients and 43.9 percent among those with an advanced degree).

Previously ignored by population-health research, pain has recently emerged as a key area of study due to its outsized impact on individuals, families and economies around the world.

"In pain we are talking about an incredibly important indicator of health," Zajacova said. "As the number one reason we go to the doctor, chronic pain afflicts more people than heart disease, diabetes and cancer combined."

The financial costs of pain are huge—economists estimated that $100-billion worth of productivity is lost each year in the United States alone.

While the reasons behind the high-school/college dropout anomalies are complex and largely unknown, Zajacova said these two groups have proven to be the exception in other health characteristics as well.

"It could be psychological characteristics we couldn't capture," she said. "Maybe it is a combination of dashed hopes. Maybe it is feeling stigmatized for being a high-school or college dropout. But this is largely speculation. We don't yet know why they have more pain than would be expected, but it signals an area of further study."

The research also highlights the need for further investigation into the causes of these complex inequities in chronic pain among US adults.

The study, The Relationship Between Education and Pain Among Adults Aged 30-49 in the United States, was published in a recent edition of The Journal of Pain.