Document Type : Original Article


1 Department of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA

2 Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USA

3 Marginalization-Related Diminished Returns Center, Los Angeles, CA 90059, USA

4 Division of General Internal Medicine, Department of Medicine, Toronto General Hospital, Canada

5 Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA

6 School of Business, University of Maryland Global Campus (UMGC), Adelphi, 20783, USA



Background: The broad scientific community generally associates high socioeconomic status (SES) with better health. However, the protective effects of high educational attainment on health may be weaker for racial and ethnic minorities than non-Latino White individuals. It is important to study whether this difference holds for chronic pain among Black and Latino individuals.
Objectives: To compare the association between educational attainment and chronic pain in the US, considering the racial and ethnic background of individuals.
Methods: The current study used baseline data from the Population Assessment of Tobacco and Health (PATH-Adults) study. All participants were 18+years old. A total number of 28204 Non-Latino, Latino, White, and Black individuals were enrolled. The outcome was chronic pain treated as a continuous measure. The predictor was educational attainment. Moderators were race and ethnicity.
Results: Our linear regressions in the pooled sample showed that higher educational attainment was associated with a lower level of chronic pain; however, this association was weaker for Latinos and Blacks compared to non-Latino and White individuals. Our stratified models also showed that higher educational attainment was more consistently associated with a lower level of chronic pain for non-Latino White individuals than racial and ethnic minorities.
Conclusion: The presumed protective effect of educational attainment against chronic pain among individuals varies between different racial and ethnic groups. Future research should test the role of stressful jobs and working conditions in weakening the protective effects of SES against chronic pain for Blacks and Latinos compared to non-Latino White individuals.