Korean J Pain.  2017 Jan;30(1):34-43. 10.3344/kjp.2017.30.1.34.

“I'm healthy, I don't have pain”- health screening participation and its association with chronic pain in a low socioeconomic status Singaporean population

• Wee LE
• Sin D
• Cher WQ
• Li ZC
• Tsang T
• Shibli S
• Koh G

• KMID: 2365339
• DOI: http://doi.org/10.3344/kjp.2017.30.1.34

Abstract

BACKGROUND
We sought to determine the association between chronic pain and participating in routine health screening in a low socioeconomic-status (SES) rental-flat community in Singapore. In Singapore, ≥ 85% own homes; public rental flats are reserved for those with low-income.
METHODS
Chronic pain was defined as pain ≥ 3 months. From 2009−2014, residents aged 40−60 years in five public rental-flat enclaves were surveyed for chronic pain; participation in health screening was also measured. We compared them to residents staying in adjacent owner-occupied public housing. We also conducted a qualitative study to better understand the relationship between chronic pain and health screening participation amongst residents in these low-SES enclaves.
RESULTS
In the rental-flat population, chronic pain was associated with higher participation in screening for diabetes (aOR = 2.11, CI = 1.36−3.27, P < 0.001), dyslipidemia (aOR = 2.06, CI = 1.25−3.39, P = 0.005), colorectal cancer (aOR = 2.28, CI = 1.18−4.40, P = 0.014), cervical cancer (aOR = 2.65, CI = 1.34−5.23, P = 0.005) and breast cancer (aOR = 3.52, CI = 1.94−6.41, P < 0.001); this association was not present in the owner-occupied population. Three main themes emerged from our qualitative analysis of the link between chronic pain and screening participation: pain as an association of "major illness"; screening as a search for answers to pain; and labelling pain as an end in itself.
CONCLUSIONS
Chronic pain was associated with higher cardiovascular and cancer screening participation in the low-SES population. In low-SES populations with limited access to pain management services, chronic pain issues may surface during routine health screening.

Keyword

Asian; Chronic pain; Health screening; Low-income; Mixed methods; Qualitative

MeSH Terms

Asian Continental Ancestry Group
Breast Neoplasms
Chronic Pain*
Colorectal Neoplasms
Dyslipidemias
Early Detection of Cancer
Humans
Mass Screening*
Pain Management
Public Housing
Singapore
Social Class*
Uterine Cervical Neoplasms

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