Family support as a pain protective factor for African American older adults: latent class analyses across 2 national longitudinal data sets

Family relationships dynamically affect pain outcomes. However, less is known about African American family relationships and chronic pain incidence and persistence. Using theoretically driven group characterizations of family emotional climate (FEC; Strained, Supportive, and Disengaged) across multiple relationship types, we conducted latent class analyses in 2 nationally representative data sets (Midlife in the United States [MIDUS]; Health Retirement Study [HRS]) aimed to identify a more ecologically valid model of family relationships and determine how the identified FEC groups, separately and concurrently, connect to chronic pain incidence and persistence for aging African Americans. For the family-only models in MIDUS and HRS, using logistic regression, Strained FEC compared with Supportive FEC increased the risk of pain incidence (odds ratio [OR] = 2.06) in MIDUS and the risk of pain persistence (OR = 2.14) in HRS. The next models extended to include parent-child relationships in HRS identified 4 FEC groups (eg, Strained Family and Parent-Child, Supportive and Strained Family and Parent-Child, Supportive Family and Parent-Child, and Disengaged Family and Parent-Child FEC). Again, using logistic regression, we identified a greater risk of pain incidence was linked to Strained Family and Parent-Child FEC (OR = 1.36) and Supportive and Strained Family and Parent-Child FEC (OR = 1.22), although not Disengaged Family and Parent-Child FEC (OR = 0.71). Strained Family and Parent-Child FEC also related to greater risk of pain persistence (OR = 1.89) compared with Supportive Family and Parent-Child FEC. These findings suggest utilization of a multidimensional modeling of family relationships to contextualize pain outcomes for aging African Americans.