Social mobility and musculoskeletal and multisite pain among young and early midlife Finns

Background

Pain is a significant public health challenge, and low adult socioeconomic position (SEP) is linked to adverse pain outcomes. However, the association between intergenerational social mobility and musculoskeletal pain across different body sites remains less well understood.

Methods

The study population consisted of 4992 Helsinki Health Study respondents aged 19–39 years in 2017 (80% women). Parental and own education were used to classify intergenerational social mobility into stable high (33%), upward (33%), downward (10%), or stable low (24%) categories. Current pain was recorded for five body regions (neck or shoulders, lower back, upper and lower extremities, and head). Pain sites were summarized into a composite variable classified as no pain, single-site pain, or multisite pain (≥2 sites), with no pain as the reference. Logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs), adjusting for sociodemographic and health-related factors.

Results

Overall, 43% reported current pain, most commonly in the neck or shoulders (31%) or lower back (22%),whereas 28% reported multisite pain. Any current pain was more prevalent among women (45%) than men (35%), but no interaction between social mobility and gender was found. Participants in the downward (OR 1.40, 95% CI 1.13–1.74) and stable low social mobility groups (OR 1.65, 95% CI 1.41–1.94) had higher odds of any current pain compared with the stable high group, after adjustment. Similar patterns were seen across pain sites. The strongest associations were observed for multisite pain, with elevated odds in both the downward (OR 1.55, 95% CI 1.21–1.99) and stable low groups (OR 1.97, 95% CI 1.64–2.36).

Conclusions

The unequal distribution of pain across social mobility groups highlights the relevance of socioeconomic inequalities for pain, suggesting that addressing these, including in early working life, may help reduce the societal and public health burden of pain.

Key messages

• Pain is common among young and early midlife individuals with decades of working life ahead, underscoring the importance of early identification and targeted measures for sustained work participation.

• The strongest associations with pain were observed among social mobility groups with low own education. These groups experience a higher burden and therefore likely warrant attention in interventions.