Pain During Midlife: A Cross-National Analysis of Cohort Differences in Reports of Pain in the United States, Europe, South Korea, and Mexico.

Middle-aged Americans today are reporting poorer mental, cognitive, and physical health compared to previous cohorts, but this trend has not been consistently observed in other nations. It is an open question whether pain shows similar cohort differences amongst U.S. middle-aged adults compared to other nations. We used harmonized data on pain from nationally representative longitudinal panel surveys from the U.S., 13 European nations (England, Continental, Mediterranean, and Nordic regions), South Korea, and Mexico to directly quantify cohort similarities and differences in midlife pain. Results from multilevel models demonstrated that midlife pain is higher amongst later-born cohorts in the U.S. than among earlier-born cohorts. The increased odds for later-born cohorts emerged in the early years of midlife when people are in their early 50s. A similar pattern of increased odds of reporting pain for later-born cohorts was observed in England and Mexico. In contrast, a decreased odds of reporting pain for later-born cohorts was observed in Continental, Mediterranean, and Nordic Europe as well as South Korea. Results for pain severity revealed a highly similar pattern. Our discussion focuses on potential explanations, including population-level discrepancies in use and quality of healthcare services and how pain is conceptualized across nations.