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

项目总结/摘要 这个关于慢性疼痛人口统计学的项目将使用人口统计学数据、方法和理论， 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通过极大地改善美国的公共卫生， 扩大关于慢性疼痛的模式和趋势的科学知识基础，疼痛与残疾的联系 和死亡率，以及可以减轻疼痛负担的个体和人群水平因素。 通过对大型、纵向或重复的横截面数据集（主要是美国， 但也加拿大和欧洲的比较目的），这项研究将推进四个具体目标： 目标1：确定慢性疼痛的患病率和社会分布的国家和地区趋势。 目的2：确定个人水平和背景因素，塑造疼痛的时间和社会模式。 目标3：从理论和经验上将慢性疼痛纳入残疾模型。 目的4：研究慢性疼痛与死亡率之间的关系。 这项研究是重要和及时的，因为慢性疼痛是该国最常见的，昂贵的， 残疾人的健康问题，社会分布极不平等。慢性疼痛也与许多 最令人不安的当代美国健康趋势，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 这本身就是一个重大问题，也是美国人口健康最近不利趋势中的一个潜在缺失环节 更广泛地说。 这项研究是创新的，因为人口学领域几乎完全忽视了慢性病的主题。 疼痛，尽管疼痛是（也许是）残疾的主要原因，是死亡率的有力预测因素， 健康方面社会差距的主要因素。对疼痛或疼痛差异的长期趋势知之甚少， 这种趋势的跨国差异，形成这种趋势的个人或背景（区域或国家）因素， 趋势，疼痛在残疾发展中的作用，或疼痛对死亡率模式的贡献。 这个项目将在健康和老龄化人口学中建立一个新的子领域， 话题研究结果将阐明卫生政策和实践如何最好地预防和解决慢性疼痛， 健康老龄化，并提高美国人口的整体健康。

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.