The association between loneliness and pain, and the role of physical health and distress: an analysis in 139 countries.

Loneliness has been found to be associated with high levels of physical pain, health problems, and poor mental health. Questions remain about how these factors are interrelated and how the relationships vary across sexes and the lifespan. Here, we used data from the 2023 and 2024 Gallup World Poll (GWP) to explore global associations between loneliness and physical pain, while accounting for health problems, and psychological distress. Our sample had data from 256,760 individuals aged 15-100 from 139 countries. Fully adjusted regressions showed that lonely individuals had 2.1 times higher odds of experiencing physical pain, had 1.8 times higher odds of having health problems, and were 25.8% more likely to experience distress than non-lonely ones. Demographic characteristics and satisfaction with social support and opportunities to meet people statistically accounted for 14% of the association between loneliness and pain. Health problems statistically accounted for 18.9% of the same association, whereas distress statistically accounted for 60.2%. In formal regression models, the associations between loneliness and pain were slightly more pronounced in females than males, but similar across ages. Our findings show a strong association between loneliness and physical pain, that was to a large degree statistically accounted for by psychological distress, and to a lesser extent by physical health, and socio-economic disadvantage. Importantly, these associations varied in strength across countries, pointing towards the importance of cultural factors. These findings shed light on the necessity for further cross-cultural and longitudinal research into the relationship among loneliness, pain, and distress.