Barriers to healthcare up risk of chronic pain

Social and environmental factors, particularly those related to access to healthcare, affect the risk of chronic pain among adolescents, a recent study has shown.

Researchers retrieved data from the Add Health Study, a longitudinal and nationally-representative public health survey of adolescents across the US. A total of 6,505 adolescents (mean age, 14.87±1.73 years; 51.6 percent female) were enrolled at baseline and were followed for three waves. Variables of interest included chronic pain, household income, and health insurance, among others.

Nearly a quarter (21.8 percent) of the participants reported chronic pain. This was more common in females than in males (25.5 percent vs 18.0 percent; p<0.001), and in Native American youth (32.1 percent). Most of the participants (56 percent) had private insurance, while only 32 percent had public health insurance plans; 12 percent had no insurance.

In the overall sample, being female (odds ratio [OR], 1.61, 95 percent confidence interval [CI], 1.30–1.99; p<0.001) was a significant risk factor for chronic pain. The same was true for experiencing violence (OR, 1.07, 95 percent CI, 1.01–1.14; p<0.05) and feeling unsafe in their environment (OR, 1.08, 95 percent CI, 1.03–1.13; p<0.01).

Notably, having barriers to healthcare also emerged as a significant risk factor for chronic pain (OR, 1.25, 95 percent CI, 1.19–1.31; p<0.001). This remained a significant risk factor in both White and Black youth.

The said barriers included having no means to travel to a care centre, having no one to go along with them, experiencing difficulties in making appointment, fear of the doctor and medical advice, and inability to pay for care.