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

Paper 2: Socioeconomic Status and Back Pain Disability

   This unpublished case study, performed by a group in Norway comes to a rather straightforward conclusion. Through census data, the testers discovered that there was a "stepwise monotonic relationship between socioeconomic position and disability retirement from back pain...that...could not be solely related to manual vs. non-manual jobs".(2) Early retirement, they argued, is the extreme endpoint of a disabling injury. Being rendered unable to work is a great burden to the individual and only happens in dire situations. Although the case study offers no conclusions about why this trend exists, I believe it backs up my hypothesis. It suggests that the lower class is much more likely to under treat or ignore their pain. Disability retirement from back pain is often the result of repeated stress on the back. Without proper care or protection, the back eventually gives out, disabling the victim. The reason the poor community is at higher risk to being disabled from work is because of their negligence towards their health. Although this paper does refute my hypothesis that pain can be attributed solely to the poor community having more physically demanding jobs, it does not disprove its influence entirely. The undertreatment of pain demonstrated in this test can be attributed to the dependence on perceived physical health mentioned in the hypothesis and insufficient knowledge on how to treat and prevent long term injuries from developing.

   The dependence on perceived physical health is a phenomena we have discussed before in class. Case studies such as Sherman's "Sensitivity of Pain" reveal that physical laborers are much less expressive of their pain.(5) Whether that is a result of their grueling occupation, a front to demonstrate their manhood, or, in my opinion, a developed instinct to avoid being seen as weak and incapable of performing their job is difficult to determine. However, it seems reasonable that poor workers would be less likely to bring up issues regarding their health than rich workers. They lack the financial security to obtain proper health care and can not afford to lose their jobs for a significant amount of time. This results in a large amount of undertreated injuries and unecessary pain, increasing the chance for serious, long term injuries in the future.

   As for lack of knowledge, paper 1 shows a clear link between the obliviousness of the lower class and the amount of pain a person endures. This test reenforces that link stating that "education... appeared to have an impact on disability retirement...each year of formal education was independently associated with decreased risk for disability retirement".(2) This statement agrees with my hypothesis that lack of knowledge results in the lower class enduring more pain.

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