Kevin Pang
PSYC144: Psychobiology and Culture of Pain
Fall 2003
Final Project

Paper 1: Socioeconomic Variations in Responses to Chest Pain

   This case study was performed by Helen Mary Richards, Margaret Elspeth Reid, and Graham Charles Murray Watt in Glasgow, Scotland. The purpose of the study was to "explore and explain socioeconomic variations in perceptions of and behavioral responses to chest pain".(1) The test participants consisted of 30 poor respondents (15 male, 15 female) and 30 affluent respondents (also 15 male, 15 female) from Glasgow. The tests performed were qualitative interviews observing whether or not there were any differences in how the rich and poor perceived pain.

   The researchers found distinct differences in how the poor and rich interviewees discussed pain. The first distinction they mention is how differently the test groups perceived their vulnerability to heart disease. The researchers found that the poor interviewees felt much more vulnerable to heart disease than the rich. Much of this fear stemmed from stereotypes and misconceptions about heart disease. The poor interviewees frequently accepted that since their family had a history of heart disease that they would inevitably get it as well. The rich interviewees, on the other hand, displayed a much more confident and optimistic outlook on their chances of developing a heart disease. The rich interviewees presented family histories of illness as isolated events and believed that heart disease could be avoided by living a healthy lifestyle. Furthermore, the rich interviewees were more inclined to point out reasons why people developed heart disease, blaming the victims for smoking too much or being obese instead of accepting it as an inevitable biological mystery.

   This difference in perceived vulnerability fits my hypothesis. Specifically, it shows that the poor are less informed than the rich and that this lack of knowledge directly affects their perception of pain. The poor interviewees in the experiment were convinced that heart disease was a burden that they would have to live with while the rich interviewees felt they could fight off the disease with proper knowhow.

   In addition to these findings, the testers also found that the poor interviewees felt more helpless about their health and would writing off their health problems as an unavoidable part of age and work. One respondent, when asked about his health, said "I'm gettin' a lot of pain in my chest for some unknown reason...I think it's auld age.", then argued that he should feel lucky since many of his friends never made it to his age.(1) Another respondent, when asked about his chest pain, said "I just thought...you've had to work long hours...I thought it was just tiredness, that's all".(1) The poor interviewees demonstrated a feeling of helplessness and acceptance when it came to pain. Furthermore, they felt it unnecessary to discuss their pain with doctors. The general perception on health care among the poor interviewees was that it would not save them from illness. The poor interviewees felt that they were bothering the doctor and complained that they did not understand how the treatments worked. They also reported that health care was more difficult to obtain as a member of the poor community and that interaction with doctors was often brief and not reassuring since doctors neglected to explain what was wrong to them. This phenomenon was most likely due to doctors assuming their poor clients would either not understand or care about the causes of the illness. In contrast, the rich interviewees expressed close ties to health care workers and felt as though they had privileged access to health care facilities. One respondent reported that he would undergo precautionary tests because he felt he had a right to make sure he was completely healthy.

   The perception of health care in this cast study supports my hypothesis. The poor interviewees demonstrated a clear lack of knowledge towards health care and were quick to self diagnose themselves because of it. Furthermore, they did not feel as though they had a right to demand proper health care and seemed content to accept their pain as a part of life. The poor felt helpless while the rich felt in control of their health revealing a link between socioeconomic status and attitudes towards health care.

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