Psychosocial Mechanisms of Socioeconomic Inequalities in Chronic Pain among White Adults in Nashville

Abstract

Although pain has grown among all racial and socioeconomic (SES) groups over the past decade, reports indicate that White and low SES individuals tend to report higher levels of pain than their minority and high SES counterparts. Drawing on data from the Nashville Stress and Health Study (n = 619), this article examines the role that psychosocial mechanisms play in the relationship between SES and pain among White individuals. We find that perceived powerlessness, subjective social status, and discrimination all help explain why low SES White individuals have higher levels of pain than high SES White individuals. We also evaluate the relative contribution of each of these mechanisms in the SES-pain relationship using causal mediation techniques. Findings indicate that powerlessness explained 50 percent of the association between SES and pain, subjective social status explained approximately 19 percent, and discrimination explained approximately 17 percent.