The pain of low status: the relationship between subjective socio-economic status and analgesic prescriptions in a Scottish community sample

Abstract

There is a strong positive relationship between objective measures of socio-economic status (OSS) and general health. However, there is an increasing interest in the relationship between health and subjective socio-economic status (SSS), which describes one’s perceived rank in relation to the rest of the society, based on factors such as income, occupation and education. While the relationship between SSS and general health is well established, the relationship between SSS and pain has received little attention. Gathering both self-report questionnaire data and General Practitioner medical data from a large representative community sample in Scotland between 2012 and 2013 (N = 1824), we investigated the relationship between SSS and prescriptions for analgesic drugs. We found that higher levels of SSS significantly predicted lower odds of participants having been prescribed at least one analgesic drug in the previous six months. We obtained this result even after controlling for OSS-related variables (education, occupational status and geographical location) and demographic variables (age and gender). This suggests that, just like the relationship between SSS and general health, SSS has important effects on pain that go beyond the influence of OSS.

Keywords:

• socio-economic status
• subjective socio-economic status
• objective socio-economic status
• pain
• psychosocial determinants of pain
• analgesics
• health

Acknowledgements

We were also assisted by the Scottish Primary Care Research Network (SPCRN) during data collection. The ESRC and SPCRN had no involvement in the study’s design, data collection, data analysis, data interpretation, or the writing and submission of this article.

Additional information

Funding

This research was made possible by a research grant awarded by the Economic & Social Research Council (ESRC) to the second, third, and fourth authors [grant number ES/I038349/1].