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The European Epidemic : pain prevalence and socioeconomic inequalities in pain across 19 European countries.

Todd, Adam and McNamara, Courtney L. and Balaj, Mirza and Huijts, Tim and Akhter, Nasima and Thomson, Katie and Kasim, Adetayo and Eikemo, Terje A and Bambra, Clare (2019) 'The European Epidemic : pain prevalence and socioeconomic inequalities in pain across 19 European countries.', European journal of pain., 23 (8). pp. 1425-1436.


Background: Using data from the European Social Survey (ESS) 2014, this study presents an update of pain prevalence amongst men and women across Europe and undertakes the first analysis of socioeconomic inequalities in pain. Methods: Data from the ESS 2014 survey were analysed for three pain variables: back/neck pain (n=11,032), arm/hand pain (n=5,954), and foot/leg pain (n=6,314). Education was used as the indicator of socio‐economic status (SES). Age adjusted risk differences (ARD) and age adjusted risk ratios (ARR) were calculated from predicted probabilities generated by means of binary logistic regression. These analyses compared the lower education group with the higher education group (the socioeconomic gap), and the medium education group with the higher education group (the gradient). Results: High prevalence rates were reported for all three types of pain across European countries. At a pan‐European level, back/neck pain was the most prevalent with 40% of survey participants experiencing pain; then hand/arm pain at 22%, and then foot/leg pain at 21%. There was considerable cross‐national variation in pain across European counties, as well as are significant socio‐economic inequalities in the prevalence of pain – with social gradients or socio‐economic gaps evident for both men and women; socio‐economic inequalities were most pronounced for hand/arm pain, and least pronounced for back/neck pain. The magnitudes of the socioeconomic pain inequalities differed between countries, but were generally higher for women. Conclusions: Future strategies to reduce the burden of pain should acknowledge and consider the associated socioeconomic inequalities of pain to ensure the ‘pain gap’ does not widen.

Item Type:Article
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Publisher statement:This is the accepted version of the following article: Todd, Adam, McNamara, Courtney L., Balaj, Mirza, Huijts, Tim, Akhter, Nasima, Thomson, Katie, Kasim, Adetayo, Eikemo, Terje A & Bambra, Clare (2019). The European Epidemic: pain prevalence and socioeconomic inequalities in pain across 19 European countries. European Journal of Pain 23(8): 1425-1436 which has been published in final form at This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Date accepted:21 April 2019
Date deposited:07 May 2019
Date of first online publication:30 April 2019
Date first made open access:30 April 2020

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