GOS Institute of Child Health, University College London, London, UK.
Department of Anaesthesia and Pain Medicine, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK.
BMJ Open. 2019 Mar 7;9(3):e024250. doi: 10.1136/bmjopen-2018-024250.
To investigate associations between a range of different indicators of socioeconomic position (SEP: occupational class, education, household overcrowding and tenure, and experience of financial hardship) across life and chronic widespread and regional pain (CWP and CRP) at age 68.
Prospective birth cohort; the Medical Research Council National Survey of Health and Development.
England, Scotland and Wales.
Up to 2378 men and women who have been followed-up since birth in 1946 to age 68.
On the basis of their self-report of pain at age 68, participants were classified as: CWP (American College of Rheumatology criteria), CRP (pain of at least 3 months' duration but that does not meet the definition of CWP), other pain (<3 months in duration) or no pain.
At age 68, the prevalence of CWP was 13.3% and 7.8% in women and men, respectively, and that of CRP was 32.3% and 28.7% in women and men, respectively. There was no clear evidence that indicators of SEP in childhood or later adulthood were associated with pain. Having experienced (vs not) financial hardship and being a tenant (vs owner-occupier) in earlier adulthood were both associated with an increased risk of CWP; for example, moderate hardship adjusted relative risk ratio (RRR) 2.32 (95% CI: 1.19 to 4.52) and most hardship RRR 4.44 (95% CI: 2.02 to 9.77). Accumulation of financial hardship across earlier and later adulthood was also associated with an increased risk of CWP.
Consideration of socioeconomic factors in earlier adulthood may be important when identifying targets for intervention to prevent CWP in later life.
研究一生中一系列不同的社会经济地位（SEP：职业阶层、教育程度、家庭拥挤程度和居住年限以及经济困难经历）指标与 68 岁时慢性广泛和区域性疼痛（CWP 和 CRP）之间的关联。
前瞻性出生队列；医学研究委员会全国健康与发展调查。
英格兰、苏格兰和威尔士。
自 1946 年出生以来一直随访至 68 岁的 2378 名男性和女性。
根据他们在 68 岁时的疼痛自我报告，参与者被分为：CWP（美国风湿病学院标准）、CRP（疼痛持续至少 3 个月但不符合 CWP 定义）、其他疼痛（持续时间<3 个月）或无疼痛。
在 68 岁时，女性的 CWP 患病率为 13.3%，男性为 7.8%，CRP 的患病率为女性 32.3%，男性为 28.7%。没有明确的证据表明儿童期或成年后期的社会经济地位指标与疼痛有关。在成年早期经历（与未经历相比）经济困难和作为租户（与自住房主相比）都与 CWP 的风险增加有关；例如，中度困难调整后的相对风险比（RRR）为 2.32（95%CI：1.19 至 4.52），最困难 RRR 为 4.44（95%CI：2.02 至 9.77）。成年早期和后期经济困难的积累也与 CWP 的风险增加有关。
在确定针对晚年 CWP 的干预目标时，考虑成年早期的社会经济因素可能很重要。
