Loneliness and pain among community-dwelling middle-aged and older Black, Latino, and White adults in the United States

IF 3 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Frontiers in Public Health Pub Date : 2024-09-18 DOI:10.3389/fpubh.2024.1429739

David Camacho, Denise Burnette, Maria P. Aranda, Jerad H. Moxley, Ellen P. Lukens, M. Carrington Reid, Elaine Wethington

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Abstract

BackgroundPrior research has demonstrated a strong and independent association between loneliness and pain, but few studies to date have explored this relationship in racially and ethnically diverse groups of midlife and older adults. We drew on the diathesis stress model of chronic pain and cumulative inequality theory to examine the relationship of loneliness and the presence and intensity of pain in a nationally representative sample of Black, Latino, and White adults aged 50 or older in the United States.MethodsData were from Wave 3 of the National Social Life, Health, and Aging Project (n = 2,706). We used weighted logistic and ordinary least squares regression analyses to explore main and interactive effects of loneliness and race and ethnicity while adjusting for well-documented risk and protective factors (e.g., educational attainment, perceived relative income, inadequate health insurance, perceived discrimination) and salient social and health factors.ResultsAlmost half (46%) of the participants reported feeling lonely and 70% reported the presence of pain. Among those who reported pain (n = 1,910), the mean intensity score was 2.89 (range = 1–6) and 22% reported severe or stronger pain. Greater loneliness was associated with increased odds of pain presence (AOR = 1.154, 95% CI [1.072, 1.242]) and higher pain intensity (β = 0.039, p < 0.01). We found no significant interaction effects involving Black participants. However, Latino participants who reported greater loneliness had significantly higher levels of pain (β = 0.187, p < 0.001) than their White counterparts with similar levels of loneliness.DiscussionLoneliness is an important correlate of pain presence and intensity and may have a stronger effect on pain intensity among Latino adults aged 50 or older. We discuss clinical and research implications of these findings, including the need for more fine-grained analyses of different types of loneliness (e.g., social, emotional, existential) and their impact on these and other pain-related outcomes (e.g., interference). Our findings suggest a need for interventions to prevent and manage pain by targeting loneliness among middle-aged and older adults, particularly Latino persons.

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美国居住在社区的中老年黑人、拉丁裔和白人成年人的孤独感和疼痛感

背景以往的研究表明，孤独感与疼痛之间存在着强烈而独立的联系，但迄今为止，很少有研究在种族和民族多元化的中老年人群体中探讨这种关系。我们借鉴了慢性疼痛的综合压力模型和累积不平等理论，研究了在美国具有全国代表性的 50 岁或以上黑人、拉丁裔和白人成年人样本中，孤独感与疼痛的存在和强度之间的关系。我们使用加权逻辑回归分析和普通最小二乘法回归分析来探讨孤独感与种族和民族的主要影响和交互影响，同时对已证实的风险和保护因素（如教育程度、感知的相对收入、医疗保险不足、感知的歧视）以及突出的社会和健康因素进行调整。在报告疼痛的参与者（n = 1,910）中，平均疼痛强度为 2.89 分（范围 = 1-6），22% 的人报告了严重或更强烈的疼痛。孤独感越强，出现疼痛的几率越大（AOR = 1.154，95% CI [1.072，1.242]），疼痛强度越高（β = 0.039，p &p;lt;0.01）。我们发现黑人参与者没有明显的交互效应。讨论孤独是疼痛存在和强度的重要相关因素，在 50 岁或以上的拉丁裔成年人中，孤独对疼痛强度的影响可能更大。我们讨论了这些发现的临床和研究意义，包括需要对不同类型的孤独感（如社交孤独感、情感孤独感、存在孤独感）及其对这些和其他疼痛相关结果（如干扰）的影响进行更精细的分析。我们的研究结果表明，有必要针对中老年人，尤其是拉丁裔中老年人的孤独感采取干预措施，以预防和控制疼痛。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Public Health Medicine-Public Health, Environmental and Occupational Health

CiteScore

4.80

自引率

7.70%

发文量

4469

审稿时长

14 weeks

期刊介绍： Frontiers in Public Health is a multidisciplinary open-access journal which publishes rigorously peer-reviewed research and is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians, policy makers and the public worldwide. The journal aims at overcoming current fragmentation in research and publication, promoting consistency in pursuing relevant scientific themes, and supporting finding dissemination and translation into practice. Frontiers in Public Health is organized into Specialty Sections that cover different areas of research in the field. Please refer to the author guidelines for details on article types and the submission process.