The Demography of Chronic Pain: A Population Approach to Pain Trends, Pain Disparities, and Pain-Related Disability and Death

项目摘要/摘要 这个关于慢性疼痛的人口学项目将使用人口学数据、方法和理论来 全面调查慢性疼痛的患病率、分布、长期 趋势、前兆和后果。该项目的长期目标是大大提高美国的公共卫生水平 扩大关于慢性疼痛的模式和趋势、疼痛与残疾的联系的科学知识库 和死亡率，以及个人和人口层面的因素，可以减轻疼痛负担。 通过对大的、纵向的或重复的横截面数据集(主要是美国的， 但出于比较的目的，这项研究将提出四个具体目标： ·目标1：查明慢性疼痛的流行率和社会分布方面的国家和区域趋势。 ·目标2：确定影响疼痛的时间和社会模式的个人层面和背景因素。 ·目标3：从理论和经验上将慢性疼痛纳入残疾模型。 ·目标4：调查慢性疼痛与死亡率之间的关系。 这项研究意义重大且及时，因为慢性疼痛是该国最常见、最昂贵和最 导致健康问题，社会分配严重不平等。慢性疼痛也与许多 当代美国最令人不安的健康趋势，包括阿片类药物流行，自杀率上升， 中年残疾和死亡率，以及健康和死亡率方面日益严重的教育不平等。因此疼痛既是一种 本身就是一个主要问题，也是最近美国人口健康不利趋势中潜在的缺失一环 更广泛地说。 这项研究具有创新性，因为人口学领域几乎完全忽视了慢性病这一主题 疼痛，尽管疼痛是导致残疾的主要原因，是死亡的有力预测因素，而且 造成社会健康差距的主要因素。人们对疼痛或疼痛差异的长期趋势知之甚少， 影响这种趋势的个人或背景(区域或国家)因素的跨国差异 疼痛在残疾发展中的作用，或疼痛对死亡模式的贡献。 该项目将在健康和老龄化人口学中建立一个新的子领域，研究这些 主题。调查结果将阐明卫生政策和做法如何最好地预防和解决慢性疼痛、支持 健康老龄化，增强美国整体人口健康。

PROJECT SUMMARY / ABSTRACT This project on the Demography of Chronic Pain will use demographic data, methods, and theories to comprehensively investigate high-priority questions about chronic pain's prevalence, distribution, long-term trends, precursors, and consequences. The project's long-term goal is to enhance U.S. public health by greatly expanding the scientific knowledge base regarding patterns and trends in chronic pain, pain's links to disability and mortality, and individual and population-level factors that could reduce the burden of pain. Through quantitative analyses of large, longitudinal or repeated cross-sectional datasets (primarily American, but also Canadian and European for comparative purposes), this research will advance four specific aims: • Aim 1: To identify national and regional trends in the prevalence and social distribution of chronic pain. • Aim 2: To identify individual-level and contextual factors shaping temporal and social patterns in pain. • Aim 3: To theoretically and empirically integrate chronic pain into models of disability. • Aim 4: To investigate the association between chronic pain and mortality. This research is significant and timely because chronic pain is one of the country's most common, costly, and disabling health problems, with a strikingly unequal social distribution. Chronic pain is also implicated in many of the most troubling contemporary U.S. health trends, including the opioid epidemic, rising suicide rates, increasing mid-life disability and mortality, and growing educational inequalities in health and mortality. Pain is thus both a major problem in its own right, and a potential missing link in recent adverse trends in U.S. population health more broadly. This research is innovative because the field of demography has nearly completely neglected the topic of chronic pain, even though pain is a (perhaps the) leading cause of disability, a powerful predictor of mortality, and a major contributor to social disparities in health. Little is known about long-term trends in pain or pain disparities, cross-national differences in such trends, individual or contextual (regional or national) factors shaping such trends, the role of pain in development of disability, or pain's contributions to mortality patterns. This project will establish a new subfield within the demography of health and aging that investigates these topics. Findings will clarify how health policies and practices can best prevent and address chronic pain, support healthy aging, and enhance overall U.S. population health.