High-impact chronic pain incidence among US adults: a brief report focused on socioeconomic factors

<h2>Abstract</h2> <b>Introduction:</b> Epidemiological studies of contributors to high-impact chronic pain (HICP) incidence are needed to inform population health, pain prevention and management. Focused on indicators of socioeconomic position (SEP), we aimed to determine the association of SEP with HICP incidence among US adults. <b>Materials and Methods:</b> This nationally representative cohort study (2019-2020) included adults (18+ years) without baseline HICP in survey-weighted analyses (n=9,534). The primary outcome was incident HICP. Exposures were baseline indicators of SEP, namely, educational attainment, family income, work status, living arrangement, omission of medical care due to cost, and food insecurity. Results were stratified by baseline pain: no chronic pain and low-impact chronic pain (LICP). <b>Results:</b> The overall 1-year HICP cumulative incidence was 4.3% (95%CI 3.7, 4.8); higher among those with baseline LICP (14.2% [95%CI 11.8%, 16.6%] than without chronic pain (2.6% [95%CI 2.1, 3.1]). After directed acyclic graph (DAG)-informed adjustment, adults with lower SEP were generally approximately twice as likely to experience incident HICP relative to their more privileged counterparts. <b>Conclusions:</b> US adults with lower SEP had generally higher risk of HICP incidence. Multilevel solutions to socioeconomic disparities and enhanced pain care for all may be considered to improve pain burden and population health.