Reciprocal Association Between Chronic Pain and Health Insurance Type in a Population-based Longitudinal Cohort Study

Area of Science:

• Health Services Research
• Epidemiology
• Public Health

Background:

• Chronic pain significantly impacts daily activities and workforce participation in the US.
• Health insurance coverage is crucial for accessing diagnosis and management of chronic conditions.
• Workforce withdrawal due to chronic pain can lead to loss of health insurance.

Purpose of the Study:

• To investigate the reciprocal association between chronic pain and health insurance coverage (any and type) over two years in middle-aged US adults.
• To determine if chronic pain predicts future insurance type and if insurance type predicts future chronic pain.
• To understand the complex relationship between socioeconomic factors and chronic pain management.

Main Methods:

• Longitudinal cohort study design with 5,137 middle-aged participants.
• Data collected in 2018 and 2020.
• Multivariable cross-lagged logistic regression analysis to assess associations between chronic pain and insurance coverage.

Main Results:

• No association found between chronic pain and having any insurance coverage over two years.
• Public, other non-private, or no insurance in 2018 predicted increased risk of chronic pain in 2020.
• Chronic pain in 2018 predicted increased risk of public or other non-private insurance coverage in 2020.

Conclusions:

• The type of health insurance coverage is critical for predicting chronic pain in US populations.
• Reciprocal associations exist between non-private insurance and chronic pain, potentially due to treatment access or disability qualification.
• Public and other non-private insurance predict future chronic pain, and chronic pain predicts future use of these insurance types.