Objective: This study aims to determine to what extent the reporting of pain in adulthood varies by adult socio-economic status; whether there are additional long-term effects of socio-economic status in childhood; and whether any such relationships are mediated through adult psychological ill-health.
Methods: Prospective cohort study (the 1958 British Birth Cohort Study). Participants were recruited, at birth, in 1958 and were followed up throughout childhood and adulthood, most recently at 45yrs when information was collected on regional and widespread pain, and various potential mediating factors.
Results: The prevalence of shoulder, forearm, low back, knee and chronic widespread pain at 45yrs generally increased with lower adult social class. Persons in the lowest social class (compared to the highest) experienced nearly a three-fold increase in the risk of chronic widespread pain: relative risk: 2.9 (95%CI: 1.8-4.6). The strength of association varied between 1.5 and 2.0 for regional pains. Childhood social class also demonstrated a relationship with most regional pains and chronic widespread pain. With the exception of forearm pain, the magnitude of effect of childhood social status on reporting of pain in adulthood was less than that of adult social status. On multivariable analysis these relationships were partly explained by poor adult mental health, psychological distress, adverse life events and lifestyle factors.
Conclusions: These results emphasise the importance and potential impact of measures to reduce social adversity – which will have the effect of not only improving musculoskeletal health in adult life but also other major causes of morbidity.