Background Chronic pain persists over a period of time, typically for three months or more. Questions on chronic pain were included in the Health Survey for England (HSE) 2011 for the first time, as recommended by the Chief Medical Officer’s 2008 report: ‘Pain: Breaking Through the Barrier’. This landmark publication was unable to present definitive estimates of chronic pain prevalence. Results from HSE 2011 fill this gap and allow the mental health and social characteristics of those living with it to be explored.
Methods All participants who lived with chronic pain were asked about the intensity of pain, areas affected, interference with everyday life and any support received. Chronic pain grades were assigned using Von Korff’s scale ranging from Grade 0 ‘Pain Free’ to Grade IV ‘Severely limiting pain’. Results were analysed by measures of mental health, socio-economic status and the Index of Multiple Deprivation. Results will also be analysed by Healthy Foundations segmentation, which categorises segments of the population by personal motivation, material deprivation and well-being, developed by the Department of Health to improve the effectiveness of targeting health policy and interventions.
Results Overall, 31% of men and 37% of women reported experiencing any level of chronic pain, with 18% of men and 19% of women experiencing ‘severely limiting pain’; higher than the 11% previously estimated in the Chief Medical Officer’s report. Chronic pain was more prevalent among the poorest in society. Those living in the lowest income households were more likely to be living with chronic pain than those living in higher income households. The same pattern was evident by deprivation with the prevalence of chronic pain being higher among those living in more deprived areas. Mental wellbeing was associated negatively with chronic pain. Those with chronic pain were significantly more likely to report feelings of anxiety or depression; 70% of men and 68% of women with ‘Severely Limiting’ pain reported feelings of anxiety or depression compared with 17% and 22% respectively among those who were pain-free.
Conclusion The 2011 HSE data provides a new, representative, insight into the prevalence, social characteristics and mental health of living with chronic pain. Additional analysis using the Healthy Foundations segmentation will provide further insight into the social patterning of health behaviours. This is an important insight into a key health issue and highlights how chronic pain, like many other health behaviours, is socially patterned and related to other inequalities.
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