Pain as a global public health priority

Daniel S Goldberg, Summer J McGee, Daniel S Goldberg, Summer J McGee

Abstract

Background: Pain is an enormous problem globally. Estimates suggest that 20% of adults suffer from pain globally and 10% are newly diagnosed with chronic pain each year. Nevertheless, the problem of pain has primarily been regarded as a medical problem, and has been little addressed by the field of public health.

Discussion: Despite the ubiquity of pain, whether acute, chronic or intermittent, public health scholars and practitioners have not addressed this issue as a public health problem. The importance of viewing pain through a public health lens allows one to understand pain as a multifaceted, interdisciplinary problem for which many of the causes are the social determinants of health. Addressing pain as a global public health issue will also aid in priority setting and formulating public health policy to address this problem, which, like most other chronic non-communicable diseases, is growing both in absolute numbers and in its inequitable distribution across the globe.

Summary: The prevalence, incidence, and vast social and health consequences of global pain requires that the public health community give due attention to this issue. Doing so will mean that health care providers and public health professionals will have a more comprehensive understanding of pain and the appropriate public health and social policy responses to this problem.

References

    1. International Association for the Study of Pain. Unrelieved pain is a major global healthcare problem.
    1. McGee SJ, Kaylor BD, Emmott H, Christopher MJ. Defining the landscape for chronic pain ethics. Pain Med. in press .
    1. Ollila E. Global health priorities - priorities of the wealthy? Global Health. 2005;1:6. doi: 10.1186/1744-8603-1-6.
    1. Institute of Medicine. Relieving pain in America: A blueprint for transforming prevention, care, education and research.
    1. Gureje O, Von Korff M, Simon GE, Gater R. Persistent pain and well-being: a World Health Organization Study in Primary Care. JAMA. 1998;280(2):147–51. doi: 10.1001/jama.280.2.147.
    1. Harstall C, Ospina M. How prevalent is chronic pain? Pain Clinical Updates. 2003;11(2):1–4.
    1. National Center for Health Statistics. Health, United States, 2006, with special feature on pain.
    1. Reid KJ, Harker J, Bala MM, Truyers C, Kellen E, Bekkering GE, Kleijnen J. Epidemiology of chronic non-cancer pain in Europe: narrative review of prevalence, pain treatments and pain impact. Curr Med Res Opin. 2011;27(2):449–62. doi: 10.1185/03007995.2010.545813.
    1. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287–333. doi: 10.1016/j.ejpain.2005.06.009.
    1. Breivik H, Cherny N, Collett B, de Conno F, Filbet M, Foubert AJ, Cohen R, Dow L. Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncology. 2009;20(8):1420–33. doi: 10.1093/annonc/mdp001.
    1. Foley K. How well is cancer pain treated? Palliative Med. 2011;25(6):398–401.
    1. Gureje O, Simon GE, Von Korff M. A cross-national study of the course of persistent pain in primary care. Pain. 2001;9(1-2):195–200.
    1. Taylor AL. Addressing the global tragedy of needless pain: rethinking the United Nations single convention on narcotic drugs. J Law Med Ethics. 2007;35(4):556–70. doi: 10.1111/j.1748-720X.2007.00180.x. 556.
    1. Kato K, Sullivan PF, Evengård B, Pedersen NL. Chronic widespread pain and its comorbidities: a population-based study. Arch Intern Med. 2006;166(15):1649–54. doi: 10.1001/archinte.166.15.1649.
    1. Krein SL, Heisler M, Piette JD, Makki F, Kerr EA. The effect of chronic pain on diabetes patients' self-management. Diabetes Care. 2005;28(1):65–70. doi: 10.2337/diacare.28.1.65.
    1. Piette JD, Kerr EA. The impact of comorbid chronic conditions on diabetes care. Diabetes Care. 2006;29(3):725–31. doi: 10.2337/diacare.29.03.06.dc05-2078.
    1. Lee S, Tsang A, Huang YQ, Zhang MY, Liu ZR, He YL, Von Korff M, Kessler RC. Arthritis and physical-mental comorbidity in metropolitan China. J Psychosom Res. 2007;63(1):1–7. doi: 10.1016/j.jpsychores.2007.01.007.
    1. Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: a literature review. Arch Intern Med. 2003;163(20):2433–45. doi: 10.1001/archinte.163.20.2433.
    1. Arnow BA, Hunkeler EM, Blasey CM, Lee J, Constantino MJ, Fireman B, Kraemer HC, Dea R, Robinson R, Hayward C. Comorbid depression, chronic pain, and disability in primary care. Psychosom Med. 2006;68(2):262–8. doi: 10.1097/01.psy.0000204851.15499.fc.
    1. Hestbaek L, Leboeuf-Yde C, Kyvik KO. Is comorbidity in adolescence a predictor for adult low back pain? A prospective study of a young population. BMC Musculoskelet Disord. 2006;7:29. doi: 10.1186/1471-2474-7-29.
    1. Alwan A, World Health Organization 2010 Global Status Report on Noncommunicable Diseases.
    1. Daar AS, Singer PA, Persad DL, Pramming SK, Matthews DR, Beaglehole R, Bernstein A, Borysiewicz LK, Colagiuri S, Ganguly N, Glass RI, Finegood DT, Koplan J, Nabel EG, Sarna G, Sarrafzadegan N, Smith R, Yach D, Bell J. Grand challenges in chronic non-communicable diseases. Nature. 2007;450:494–96. doi: 10.1038/450494a.
    1. CSDH. Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the World Health Organization Commission on Social Determinants of Health. 2008.
    1. Mäkelä M, Heliövaara M, Sievers K, Impivaara O, Knekt P, Aromaa A. Prevalence, determinants, and consequences of chronic neck pain in Finland. Am J Epidemiol. 1991;134(11):1356–67.
    1. Heliövaara M, Mäkelä M, Knekt P, Impivaara O, Aromaa A. Determinants of sciatica and low-back pain. Spine. 1991;16(6):608–14. doi: 10.1097/00007632-199106000-00002.
    1. Brekke M, Hjortdahl P, Kvien TK. Severity of musculoskeletal pain: relations to socioeconomic inequality. Soc Sci Med. 2002;54(2):221–8. doi: 10.1016/S0277-9536(01)00018-1.
    1. Day MA, Thorn BE. The relationship of demographic and psychosocial variables to pain-related outcomes in a rural chronic pain population. Pain. 2010;151(2):467–74. doi: 10.1016/j.pain.2010.08.015.
    1. Saastamoinen P, Leino-Arjas P, Laaksonen M, Lahelma E. Socio-economic differences in the prevalence of acute, chronic and disabling chronic pain among ageing employees. Pain. 2005;114(3):364–71. doi: 10.1016/j.pain.2004.12.033.
    1. Fuentes M, Hart-Johnson T, Green CR. The association among neighborhood socioeconomic status, race and chronic pain in black and white older adults. J Natl Med Assoc. 2007;99(10):1160–9.
    1. Green CR, Hart-Johnson T. The impact of chronic pain on the health of black and white men. J Natl Med Assoc. 2010;102(4):321–31.
    1. Roth RS, Punch MR, Bachman JE. Educational achievement and pain disability among women with chronic pelvic pain. J Psychosom Res. 2001;51(4):563–9. doi: 10.1016/S0022-3999(01)00242-2.
    1. Borrell LN, Nguyen N. Racial/ethnic disparities in all-cause mortality in U.S. adults: the effect of allostatic load. Pub Health Rep. 2010;125(6):810–16.
    1. Brunner E, Marmot M. In: Social Determinants of Health. 2. Marmot M., Wilkinson RG, editor. New York: Oxford University Press; 2006. Social organization, stress, and health; pp. 6–30.
    1. Dorner TE, Muckenhuber J, Stronegger WJ, Ràsky E, Gustorff B, Freidl W. The impact of socio-economic status on pain and the perception of disability due to pain. Eur J Pain. 2011;15(1):103–9. doi: 10.1016/j.ejpain.2010.05.013.
    1. Rios R, Zautra AJ. Socioeconomic disparities in pain: the role of economic hardship and daily financial worry. Health Psychol. 2011;30(1):58–66.
    1. Sá KN, Pereira Cde M, Souza RC, Baptista AF, Lessa I. Knee pain prevalence and associated factors in a Brazilian population study. Pain Med. 2011;12(3):394–402. doi: 10.1111/j.1526-4637.2011.01063.x.
    1. Graham H. Social determinants and their unequal distribution: clarifying policy understandings. Milbank Quart. 2004;82(1):101–24. doi: 10.1111/j.0887-378X.2004.00303.x.
    1. O'Rand AM. The precious and the precocious: understanding cumulative disadvantage and cumulative advantage over the life course. Gerontologist. 1996;36(2):230–8. doi: 10.1093/geront/36.2.230.
    1. Navarro V. What we mean by social determinants of health. Int J Health Serv. 2009;39(3):423–41. doi: 10.2190/HS.39.3.a.
    1. Lantz PM, Lichtenstein RL, Pollack HA. Health policy approaches to population health: the limits of medicalization. Health Aff. 2007;26(5):1253–7. doi: 10.1377/hlthaff.26.5.1253.
    1. World Health Organization, Access to Opioid Medications in Europe. Ensuring balance in national policies on controlled substances, guidance for availability and accessibility of controlled medicines. 2011.
    1. World Health Organization Access to Controlled Medications Programme.
    1. Pain & Policy Studies Group.
    1. California Newsreel Productions. Unnatural Causes. 2008.
    1. Rose G. Sick individuals and sick populations. Int J Epidemiol. 1985;14(1):32–8. doi: 10.1093/ije/14.1.32.
    1. Benach J, Malmusi D, Yasui Y, Martínez JM, Muntaner C. Beyond Rose's strategies: a typology of scenarios of policy impact on population health and health inequalities. Int J Health Serv. 2011;41(1):1–9. doi: 10.2190/HS.41.1.a.
    1. Stonington S, Holmes SM. Social medicine in the twenty-first century. PLoS Med. 2006;3(10):e445.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj