Cowden Richard G, Chen Zhuo Job, Wilkinson Renae, Weziak-Bialowolska Dorota, Breedlove Thomas, Gundersen Craig, Shiba Koichiro, Padgett R Noah, Johnson Byron R, VanderWeele Tyler J
Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Commun Med (Lond). 2025 Apr 30;5(1):144. doi: 10.1038/s43856-025-00859-x.
Suffering has been identified as an important public health issue worthy of closer attention. This preregistered study takes an initial step toward developing an epidemiology of suffering by exploring the distribution of suffering in 22 countries and testing for sociodemographic disparities in suffering.
Using nationally representative data from the first wave of the Global Flourishing Study (N = 202,898), we estimated the proportion of people who endorsed some/a lot of suffering in each country. Variation in proportions of suffering across the categories of 9 sociodemographic characteristics (age, gender, marital status, employment status, years of education, immigration status, frequency of religious service attendance, religious affiliation, racial/ethnic identity) were estimated separately for each country. We aggregated country-level estimates of suffering for specific sociodemographic categories using random effects meta-analyses.
We find that the proportion of country-specific populations experiencing suffering varies considerably, ranging from 0.24 (Poland) to 0.60 (Türkiye). Country-level results provide evidence of cross-national heterogeneity in suffering for all sociodemographic categories, although variation is greater for some categories than others. Meta-analytic results support differences in suffering based on marital status, employment status, and years of education across the countries, with the highest suffering observed among those who have separated from their spouse, are either unemployed and looking for a job or endorse the none of these/other employment status category, and have completed 8 or fewer years of education.
Suffering varies across countries and sociodemographic categories. Our findings lay the foundation for population-level monitoring of suffering and a population health agenda to address suffering among vulnerable subpopulations.
痛苦已被视为一个值得密切关注的重要公共卫生问题。这项预先注册的研究朝着开展痛苦流行病学迈出了第一步，通过探索22个国家中痛苦的分布情况，并检验痛苦方面的社会人口统计学差异。
利用全球繁荣研究第一波的具有全国代表性的数据（N = 202,898），我们估计了每个国家认可存在一些/很多痛苦的人群比例。针对9种社会人口统计学特征（年龄、性别、婚姻状况、就业状况、受教育年限、移民身份、宗教仪式参加频率、宗教信仰、种族/族裔身份）的类别，分别估计每个国家痛苦比例的差异。我们使用随机效应荟萃分析汇总了特定社会人口统计学类别的国家层面痛苦估计值。
我们发现，不同国家经历痛苦的特定人群比例差异很大，范围从0.24（波兰）到0.60（土耳其）。国家层面的结果为所有社会人口统计学类别痛苦的跨国异质性提供了证据，尽管某些类别的差异比其他类别更大。荟萃分析结果支持各国在痛苦方面基于婚姻状况、就业状况和受教育年限的差异，在与配偶分居者、失业且正在找工作者或认可“无此类/其他就业状况”类别的人群以及受教育年限为8年及以下者中观察到的痛苦程度最高。
痛苦在不同国家和社会人口统计学类别中存在差异。我们的研究结果为在人群层面监测痛苦以及制定解决弱势群体痛苦问题的人群健康议程奠定了基础。
