Healthcare-related social determinants of health are associated with pain severity among adults with comorbid heart failure and chronic pain.

INTRODUCTION

Chronic pain worsens symptom burden and quality of life in individuals with heart failure (HF). Healthcare-related social determinants of health (SDOH) - including access (e.g., stability of coverage), affordability (e.g., medication cost-saving activities), and utilization (e.g., number of provider visits) may influence pain severity. This study aimed to describe these SDOH and examine their relationship with pain severity.

METHODS

A cross-sectional analysis was conducted using data from 4,026 adults with HF and chronic pain enrolled in the All of Us Research Program. Pain severity over 7 days (0 to 10 scale) and healthcare-related SDOH were assessed using descriptive statistics and linear regression.

RESULTS

Participants averaged 69.90 years old; 58.15% were female and 68.11% White. Although 98.48% had insurance, barriers remained: 21.82% reported transportation issues, 22.45% could not afford dental care, and 34.88% requested lower-cost prescriptions. Participants reporting more barriers to healthcare and more unaffordable healthcare services experienced significantly higher 7-day pain severity. Other variables associated with higher 7-day pain severity were age, race, sex, comorbidity, depression and fatigue.

CONCLUSIONS

Despite high insurance coverage, healthcare barriers were common and associated with increased 7-day pain severity. Future research should explore access to pain-specific services with more comprehensive pain measures.