Great Recession increased physical pain as well as economic

The Great Recession caused a spike in economic pain across the country, but with it also came a persistent increase in chronic physical pain, especially among those less educated.

This was the finding in a recent report featured by the National Bureau of Economic Research. It examined a rise in physical pain reported among Americans over the past few decades, and found that much of this increase can be attributed to a major spike that took place between 2007 and 2010, which coincides with the bursting of the real estate bubble and subsequent credit crisis, also known as the Great Recession.

"In fact, there is no evidence of any trend in pain before that event and evidence for only mild trends thereafter, at least for less educated individuals," said the paper.

Researchers examined National Health Interview Survey data from 1997 to 2018 on reports of face, neck, or lower back and leg pain. Looking at this data, the researchers found a noticeable jump in pain from the years prior to the 2007-2010 period to the years afterward that is typically much greater for men and women after their late 40s, sometimes up to a large six percentage point jump.

"This makes the upward shift in pain look much more like a period phenomenon than a cohort phenomenon," said the paper.

While there is a strong correlation between pain increases and the Great Recession, the researchers said there are several arguments against drawing a direct causal relationship. The study noted that

• The recession led to a decline in physically demanding blue collar jobs, not an increase, so it can't be office workers suddenly working as landscapers or something along those lines;
• People might be misreporting or overreporting pain in troubling economic times, but it is difficult to believe such misreporting would be so widespread, especially when similar effects were not seen in other economic downturns;
• People might have gained weight to the point where they had more health issues, but it is unlikely this would have manifested as a singular spike versus a general upward trend; and,
• While family life did decline in this same period (fewer people had babies or had children much later in life) the connection of this effect to chronic pain is tenuous.

The researchers did note, however, that psychological distress, of the kind that might come from a global financial system collapse, can trigger physiological pain. They also pointed out that, economically, major financial crises can leave economic "scarring" on people who leave good jobs and never return; there might be a similar psychological effect at play here as well.

"While speculative, it is possible that a related mechanism could occur for pain, with the well-documented economic distress induced by the Great Recession, layered on top of a long-term decline in the job quality and wages of less educated workers resulting from deindustrialization, having triggered increases in pain associated with that sudden increase in distress," said the report. "The experience of pain is filtered through personal characteristics and perceptions and is partly biological but also partly psychological and social. Distress, particularly emotional distress, can induce biological mechanisms which generate pain. While this literature has not focused on environmental stressors like job loss in a recession, it would be consistent with such a mechanism. Somewhat more directly related is the large literature on allostatic overload, which argues that cumulative stresses of life and life events and general 'wear and tear' can, at some point, lead to poorer physiological health outcomes and to chronic pain," said the report.