Pain and self-assessed health: does the association vary by age?

The association between pain and self-assessed health among adults age 20 and older is examined with data from the 2003-2004 National Health and Nutrition Examination Survey, a cross-sectional nationally representative survey of the civilian, non-institutionalized US population. Models emphasize whether and how the association differs across age cohorts. 5032 respondents age 20 and older were asked about their experience with pain. Responses are used to create two different pain measures: general and site-specific. Self-assessed health is categorized into groups that are ordered from fair/poor to excellent. Bivariate analyses and ordered logistic regressions reveal pain, measured both ways, have robust inverse associations with self-assessed health. Associations remain robust after adjusting for a series of health conditions and indicators plus demographic, socioeconomic and social support characteristics. Models test the effect of age by pain interactions on self-assessed health and confirm substantial variation across cohorts. Those of middle-age, 40-59, display the strongest association while self-assessed health is virtually unassociated among older-old, those 80 and older. Findings suggest that the way pain impacts self-assessed health varies by age cohort. Conclusions discuss the importance of considering pain as a health condition and the implications of the findings for well-being across age cohorts.