The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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"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, Liang En (Singhealth Internal Medicine, Singapore General Hospital) ;
  • Sin, David (Yong Loo Lin School of Medicine, National University of Singapore, National University Health System) ;
  • Cher, Wen Qi (Yong Loo Lin School of Medicine, National University of Singapore, National University Health System) ;
  • Li, Zong Chen (Yong Loo Lin School of Medicine, National University of Singapore, National University Health System) ;
  • Tsang, Tammy (National Psychiatry Residency Program, National Healthcare Group) ;
  • Shibli, Sabina (Department of Anaesthesia, Ng Teng Fong General Hospital, JurongHealth) ;
  • Koh, Gerald (Saw Swee Hock School of Public Health, National University of Singapore, National University Health System)
  • Received : 2016.04.05
  • Accepted : 2016.11.25
  • Published : 2017.01.01
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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, ${\geq}85%$ own homes; public rental flats are reserved for those with low-income. Methods: Chronic pain was defined as pain ${\geq}3$ 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.

Keywords

References

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