Relationship between pain severity and self-perceived health among United States adults: A cross-sectional, retrospective database study

Self-perceived health is related to outcomes such as morbidity and mortality. However, little is known about the relationship between pain severity and self-perceived health, which could be useful to know to help improve health. This study assessed the association of pain severity and other contributing factors with self-perceived health among United States adults. This cross-sectional, retrospective database study used 2019 Medical Expenditure Panel Survey data and included United States adults aged ≥18 years who responded to the pain item in the survey. The independent variable was self-reported pain severity, and the dependent variable was self-perceived health. Various potentially confounding variables were controlled for in the analysis. Adjusted logistic regression models were used to identify statistical associations between each variable and self-perceived health. The complex survey design was maintained, while nationally representative estimates were obtained. Among the sample of 17,261 United States adults, 88.1% (95% confidence interval, 87.4%-88.8%) reported excellent, very good, or good self-perceived health, while 11.9% (95% confidence interval, 11.2%-12.6%) reported fair or poor self-perceived health. In adjusted analyses, there were significant associations between fair or poor self-perceived health and any level of pain severity versus no pain, age 40 to 64 versus 18 to 39 years, male versus female, Hispanic versus non-Hispanic, high school diploma or less versus more than high school, unemployed versus employed, poor, near poor, or low versus middle or high income, fair or poor versus excellent, very good, or good mental health, exercising <5 times versus ≥5 times per week, smoker versus nonsmoker, and ≥2 versus <2 comorbid conditions. This study found that greater levels of pain severity (and several other variables) were associated with greater odds of reporting fair or poor self-perceived health. These associations provide greater insight into the variables associated with self-perceived health, which may be useful targets to improve health.