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Greater cumulative unmet social needs associated with higher pain intensity and interference in older adultsUnmet social needs like food and housing increase chronic pain

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Key Takeaway
Note that higher cumulative unmet social needs are associated with increased pain intensity and interference.

This observational study analyzed pooled pre-intervention data from randomized controlled trials involving 438 midlife and older adults (mean age 67.5 years) with chronic pain in an underserved urban setting. The study focused on the association between unmet social needs (food, housing, utilities, transportation, and social support) and pain outcomes.

Patients with three or more cumulative unmet social needs showed significantly higher pain intensity (B = 0.75, p = 0.010) and greater pain interference (B = 3.24, p = 0.002). Additionally, these patients reported lower pain self-efficacy (B = -2.04, p = 0.006). Specific social factors also showed associations: food access challenges were linked to all three pain outcomes, while transportation difficulties were linked to greater pain interference and lower self-efficacy. Insufficient social support was associated with greater pain intensity and interference (p < 0.05).

Safety and tolerability data were not reported. A primary limitation of this study is the use of pooled pre-intervention data, which means the results indicate associations at baseline rather than the effects of a specific intervention. Clinicians should consider these findings as evidence of the potential impact of social determinants on chronic pain management in urban populations.

Living with chronic pain is hard enough, but for many people, the struggle is made worse by the basic hurdles of daily life. A study of 438 middle-aged and older adults in an urban setting found a clear link between social needs and physical suffering. When people faced three or more unmet needs, like lack of food, housing, or transportation, their pain became more intense and harder to manage.

Specifically, the research showed that having fewer resources led to more pain interference, meaning the pain got in the way of daily activities more often. It also lowered a person's self-efficacy, which is the confidence they have in their ability to manage their own pain. These findings highlight how external stressors like food insecurity and lack of transportation directly impact how a person experiences and handles physical pain.

It is important to note that these results come from pre-intervention data. This means the study shows a strong connection between social struggles and pain levels at the start of a program, rather than tracking how a specific treatment changed those outcomes over time. The findings suggest that addressing basic needs is a vital part of managing chronic pain.

What this means for you:
People facing multiple social hurdles like food or housing insecurity experience more intense and harder-to-manage pain.

Common questions

How do social issues like food access affect pain?

The study found that challenges with food access were linked to all three main outcomes: pain intensity, how much pain interferes with daily life, and a person's confidence in managing their pain. These findings suggest that basic needs are closely tied to how a person experiences chronic pain.

What specific social needs were linked to more pain?

People who faced three or more unmet social needs, including food, housing, utilities, transportation, and social support, reported higher pain intensity and more interference in their daily lives. Specifically, transportation issues were linked to more interference and lower confidence in managing pain.

What does pain self-efficacy mean in this study?

Pain self-efficacy is the confidence a person has in their ability to manage their own pain. The study found that people with more unmet social needs had lower self-efficacy, meaning they felt less capable of handling their pain because of the extra stresses they faced.

Study Details

Study typeRct
EvidenceLevel 2
PublishedSep 2026
View Original Abstract ↓
IntroductionChronic pain affects over one-third of U.S. older adults, and particularly socioeconomically constrained populations. Few studies examine how unmet social needs related to the social determinants of health, including food, housing, utilities, transportation, and social support, are linked to pain. This study assessed whether cumulative and individual unmet social needs are associated with pain outcomes in a predominantly Black/African American sample of adults aged 50 years and older with chronic pain recruited from an underserved urban setting.MethodsWe pooled pre-intervention data from two randomized controlled trials of community health worker-led behavioral interventions. Multivariable linear regression examined associations of cumulative and individual unmet social needs with pain intensity, pain interference, and pain self-efficacy.ResultsAmong 438 participants, the mean age was 67.5 years, 87% (n = 380) were female, 77% (n = 338) identified as Black/African American, and 54% (n = 237) reported one or more unmet social needs. In adjusted regression models, participants with greater cumulative unmet social needs (three or more) experienced greater pain intensity (B = 0.75, p = .010), pain interference (B = 3.24, p = .002), and lower pain self-efficacy (B = −2.04, p = .006). Food access challenges were associated with all three outcomes; transportation difficulties were linked with greater pain interference and lower self-efficacy; and insufficient social support was associated with greater pain intensity and greater pain interference (p 
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