TY  - JOUR
AU  - Atlas, Steven J
AU  - Skinner, Jonathan S
TI  - Education and the Prevalence of Pain
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 14964
PY  - 2009
Y2  - May 2009
DO  - 10.3386/w14964
UR  - http://www.nber.org/papers/w14964
L1  - http://www.nber.org/papers/w14964.pdf
N1  - Author contact info:
Steven J. Atlas
General Medicine Division
Massachusetts General Hospital
50 Staniford Street
Boston MA 02114
E-Mail: satlas@partners.org

Jonathan S. Skinner
Department of Economics
6106 Rockefeller Hall
Dartmouth College
Hanover, NH 03755
Tel: 603/646-2535
Fax: 603/646-2122
E-Mail: jonathan.skinner@dartmouth.edu
M1  - published as Steven J. Atlas, Jonathan Skinner. "Education and the Prevalence of Pain," in David A. Wise, editor, "Research Findings in the Economics of Aging" University of Chicago Press (2010)

AB  - Many Americans report chronic and disabling pain, even in the absence of identifiable clinical disorders.  We first examine the prevalence of pain in the older U.S. population using the Health and Retirement Study (HRS).  Among 50-59 year females, for example, pain rates ranged from 26 percent for college graduates to 55 percent for those without a high school degree.  Occupation, industry, and marital status attenuated but did not erase these educational gradients.  Second, we used a study of patients with lower back pain and sciatica arising from intervertebral disk herniation (IDH).   Initially, nearly all patients reported considerable pain and discomfort, with a sizeable fraction undergoing surgery for their IDH.  However, baseline severity measures and surgical or medical treatment explained little of the variation in 10-year outcomes.  By contrast, education exerted a strong impact on changes over time in pain: just 9 percent of college graduates report leg or back pain "always" or "almost always" after 10 years, compared to 34 percent for people without a high school degree.  This close association of education with pain is consistent with recent research emphasizing the importance of neurological -- and perhaps economic -- factors in the perception of pain.
ER  -