title: Is experimentally induced pain associated with socioeconomic status? Do poor people hurt more?
abstract: BACKGROUND
  The association of pain and socioeconomic status is widely reported, yet much less clearly understood. The aim of this study was to investigate the association of experimentally induced pain threshold and tolerance with socioeconomic status.
  
  
  METHODS
  The study sample consisted of 319 adult subjects from the population of the island of Vis, Croatia, which was previously shown to have a high level of social homogeneity. A manual dolorimeter was used to measure mechanical pressure pain threshold (least stimulus intensity) and pain tolerance (maximum tolerance stimulus intensity) on both hands. Pain tolerance interval was defined as the difference between pain tolerance and threshold. Years of schooling and material status were used as socioeconomic estimates.
  
  
  RESULTS
  Both of the socioeconomic estimates were significantly correlated with pain threshold, tolerance, and tolerance interval (P<0.001). The mixed modeling analysis, controlled for the effects of age, gender, and 4 psychological variables, indicated that education was not a significant predictor in any of the 3 models. However, lower material status was significantly associated with lower pain tolerance (P=0.038) and narrower pain tolerance interval (P=0.032), but not with pain threshold (P=0.506). The overall percentages of explained variance were lower in the tolerance interval model (20.2%) than in pain tolerance (23.1%) and threshold (33.1%), suggesting the increasing share of other confounding variables in pain tolerance and even more so in tolerance interval model.
  
  
  CONCLUSIONS
  These results suggest a significant association between experimentally induced pain tolerance and tolerance interval with material status, suggesting that poor people indeed do hurt more.
authors.affiliation: Medical School, University of Split, Split, Croatia.
authors.forename: Ana
authors.initials: A
authors.lastname: Miljković
authors.affiliation: University Department for Health Care Studies, University of Split, Split, Croatia.
authors.forename: Ana
authors.initials: A
authors.lastname: Stipčić
authors.affiliation: Centre for Palliative Medicine, Medical Ethics and Communication Skills, Medical School, University of Zagreb, Zagreb, Croatia.
authors.forename: Marijana
authors.initials: M
authors.lastname: Braš
authors.affiliation: Centre for Palliative Medicine, Medical Ethics and Communication Skills, Medical School, University of Zagreb, Zagreb, Croatia.
authors.forename: Veljko
authors.initials: V
authors.lastname: Dorđević
authors.affiliation: Centre for Palliative Medicine, Medical Ethics and Communication Skills, Medical School, University of Zagreb, Zagreb, Croatia.
authors.forename: Lovorka
authors.initials: L
authors.lastname: Brajković
authors.affiliation: Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Caroline
authors.initials: C
authors.lastname: Hayward
authors.affiliation: Surgery Clinic, Clinical Hospital Centre Split, Split, Croatia.
authors.forename: Arsen
authors.initials: A
authors.lastname: Pavić
authors.affiliation: Medical School, University of Split, Split, Croatia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Kolčić
authors.affiliation: Medical School, University of Split, Split, Croatia.
authors.forename: Ozren
authors.initials: O
authors.lastname: Polašek
mesh_terms: D017523:Croatia; D006801:Humans; D015233:Models, Statistical; D010147:Pain Measurement / Q000379:methods; D058748:Pain Perception / Q000502:physiology*; D017288:Pain Threshold / Q000502:physiology* / Q000523:psychology; D010812:Physical Stimulation; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires