Exploring chronic pain: demographic and social determinants of health insights in Maine

Introduction: Chronic pain is a serious public health problem in Maine. We initiated a pain registry for the adult population across Maine to characterize the population with persistent or recurrent pain, with a special focus on the relationships between social determinants of health (SDOH) and chronic pain outcomes (pain level and co-morbidities) and management, therefore, to identify targeted public health interventions to improve pain care in Maine. Methods: The registry uses the REDCap data collection platform to administer an anonymous survey, which includes questions regarding pain characteristics, pain management, and demographic and SDOH factors. The survey was distributed through both hard- and electronic copies of a flyer. Results: The current study reports the initial cross-sectional descriptive analysis of the first 109 respondents with the focus on the relationships between selected socio-demographic factors and pain outcome measures. Compared to Maine's census data, the current participant pool is overrepresented in biological females, individuals 65 and older, minority racial/ethnic groups, and education attainment, but underrepresented in veterans. The majority of participants experienced pain for more than a year and described their pain as moderate to severe. Low back was the most frequently reported pain location, and trauma/injury was the most frequently identified cause. Fatigue, pain interference, reduced physical function, and sleep disturbance were major co-morbidities. Higher SDOH risk was significantly associated with worse pain-related outcomes. Being younger and having lower education levels were associated with increased anxiety and depression but reduced cognitive function. Lower education level was also associated with greater fatigue and pain score. The White-only race was associated with lower levels of anxiety, depression and sleep disturbance. Within the current participant pool, biological sex, veteran status and rural living did not significantly affect any pain outcomes. Discussion: In summary, additional recruitment efforts to reach all socio-demographic groups are warranted and further data analysis could inform research in pain and pain treatment as well as public health strategies for pain prevention in Maine.