Department of Disability and Human Development, University of Illinois Chicago, Chicago, IL, United States.
School of Social Work, Virginia Commonwealth University, Richmond, VA, United States.
Front Public Health. 2024 Sep 17;12:1429739. doi: 10.3389/fpubh.2024.1429739. eCollection 2024.
Prior 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.
Data were from Wave 3 of the National Social Life, Health, and Aging Project ( = 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.
Almost half (46%) of the participants reported feeling lonely and 70% reported the presence of pain. Among those who reported pain ( = 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 ( = 0.039, < 0.01). We found no significant interaction effects involving Black participants. However, Latino participants who reported greater loneliness had significantly higher levels of pain ( = 0.187, < 0.001) than their White counterparts with similar levels of loneliness.
Loneliness 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.
先前的研究表明，孤独与疼痛之间存在强烈且独立的关联，但迄今为止，很少有研究探讨这一关系在中年和老年的不同种族和族裔群体中的表现。我们借鉴慢性疼痛的素质-应激模型和累积不平等理论，在美国一个代表黑种人、拉丁裔和白种人 50 岁或以上的全国性样本中，研究孤独感与疼痛的存在和强度之间的关系。
数据来自国家社会生活、健康和老龄化项目的第 3 波（ = 2706）。我们使用加权逻辑回归和普通最小二乘回归分析来探索孤独感和种族与族裔的主要和交互作用，同时调整了经过充分证明的风险和保护因素（例如，教育程度、感知相对收入、医疗保险不足、感知歧视）和显著的社会和健康因素。
近一半（46%）的参与者报告感到孤独，70%的人报告有疼痛。在报告有疼痛的参与者中（ = 1910），平均强度评分为 2.89（范围 1-6），22%的人报告有严重或更强的疼痛。更大的孤独感与疼痛存在的几率增加相关（优势比 = 1.154，95%置信区间 [1.072，1.242]）和更高的疼痛强度（ = 0.039， < 0.01）。我们没有发现涉及黑人参与者的显著交互作用效应。然而，报告孤独感更高的拉丁裔参与者的疼痛水平明显高于具有相似孤独感的白人参与者（ = 0.187， < 0.001）。
孤独感是疼痛存在和强度的一个重要相关因素，可能对 50 岁或以上的拉丁裔成年人的疼痛强度有更强的影响。我们讨论了这些发现的临床和研究意义，包括对不同类型的孤独感（例如，社交、情感、存在）进行更细致分析的必要性，以及它们对这些和其他与疼痛相关的结果（例如，干扰）的影响。我们的研究结果表明，需要通过针对中年和老年人群，特别是拉丁裔人群的孤独感来干预和管理疼痛，以预防和管理疼痛。
