Sex, Income, and Education as Determinants of Chronic Pain in Mainland China

Abstract

Background: Chronic pain is a global health burden with significant impacts on daily functioning and quality of life. While previous studies have reported higher pain prevalence among females globally, emerging evidence from mainland China suggests a contrasting pattern.

Purpose: This study aimed to explore the sex differences, and interactions with socio-demographic factors, pain perception in predicting pain intensity among adults with chronic pain in mainland China.

Design: This study used a descriptive cross-sectional design.

Methods: A survey was conducted among 1,607 adults in mainland China. The Mann-Whitney U test was employed to compare mean pain intensity between sex groups. Generalized Linear Models and stepwise regression were employed to analyze associations with chronic pain.

Results: The findings revealed that males reported a higher prevalence and intensity of chronic pain compared to females. Lower income was associated with a higher likelihood of chronic pain, while higher income and lower education were significant predictors of greater pain intensity. Significant interaction effects between income, education, and sex on pain intensity were observed. Furthermore, males' pain intensity was more strongly influenced by the perception that exercise exacerbates pain, while females were more likely to view pain as a natural consequence of aging.

Conclusion: These findings challenge traditional assumptions about sex differences in chronic pain and underscore the need for sex-sensitive interventions, such as online pain management programs tailored to address the distinct socio-demographic and perceptual factors influencing men and women.

Clinical implications: Recognizing sex differences in chronic pain, particularly related to socio-demographics and pain perception, can help healthcare providers tailor pain assessment and management strategies to improve outcomes for both men and women.

Keywords: Chronic pain; Education; Income; Pain perception; Sex difference; Socio-demographic factor.