A series of studies have found a connection between economic insecurity and physical pain. Lead research Eileen Chou and colleagues were interested in how factors such as employment status, economic security, and perceived control lead to physical pain among people who experience economic insecurity.

In the first study, a sample of 33,720 households were accessed through Nielsen’s consumer panel data set, with data related to household purchases of over the counter (OTC) painkillers and employment status tracked. Results indicated that household unemployment level predicted the use of OTC painkillers.

To assess how two measures of economic insecurity–employment status and economic prospects within state of residence–predicted physical pain, the research team surveyed 187 participants in the second study. Physical pain was measured with an adapted version of the West Haven-Yale Multidimensional Pain Inventory. As with the first study, level of physical pain was predicted from employment status. Additionally, those living in states with high levels of unemployment predicted higher levels of physical pain.

In the third study, causal evidence between economic insecurity and physical pain was examined by manipulating economic insecurity. Participants were randomly assigned to either a high or low insecurity group; those in the high insecurity group reflected on a time of job and economic insecurity, while those in the low insecurity group reflected on a time when job and economic security were present. Participants (n=231) responded to an adapted version of the McGill Pain Questionnaire and the Positive and Negative Affect Schedule addressed the potential association to physical pain.

After controlling for variables such as age and current employment status, those participants who reflected on an economically insecure period had nearly double the rate of physical pain when compared to the group that reflected on a time of economic security.

In the fourth study, another causal connection was found. Participants disclosed their state of residence and were then told their state of residence had one of the highest unemployment rates—this created a high insecurity group. A second group was not notified of their state’s unemployment rate, creating a baseline condition. Among the 195 participants, current level of pain was assessed, as was sense of lack of control. When compared to the baseline group, those in the high insecurity group reported more physical pain and greater lack of control, findings consistent with researcher expectations.

Participants in a fifth study (n=100) were asked to write about an autobiographical experience based on a situation in which they either felt they did or did not have control. Assessment of current physical pain occurred immediately after this experience based on a scale from 0 (no pain) to 100 (worst pain).  Controlling for variables such as gender and current use of painkillers, those who described a lack of control reported more than double the physical pain experienced by those who described having control in a recalled situation.

A cold pressor test, which measures sensitivity to very cold water, was used to measure pain tolerance as part of Study #6—both baseline and post-manipulation measures were taken.  Via computer text, 114 participants read either content related to low or high employment security for undergraduates from certain universities. Immediately following this, participants (who were students at the University of Virginia or UVA), were directed to read college rankings for UVA. Those who read high unemployment insecurity content info also read that UVA ranking 23rd nationally, while those who read low unemployment insecurity info read that UVA held a 2nd position ranking among public universities.

Participants were then directed to write about “how an average UVA student would feel as he or she prepares to enter the job market.” A name badge indicating UVA ranking was worn by participants “to accentuate the manipulation,” and the cold pressor test was administered again. Results indicated that reflecting on economic insecurity decreased pain tolerance, while there was no change in pain tolerance among participants who reflected on economic security. In line with the other studies, a negative association was found between economic insecurity and pain tolerance post manipulation.

Altogether, these studies indicate that the subjective and objective experiences of economic insecurity play a role in the experience of physical pain. The abuse of painkillers has an impact on both medical resources and the ability to work, so these findings should be of significance to clinicians, researchers, and public policymakers. “By showing that physical pain has roots in economic insecurity and feelings of lack of control, the current findings offer hope for short-circuiting the downward spiral initiated by economic insecurity and producing a new, positive cycle of well-being and pain-free experience.”

The full results of the studies, “Economic insecurity increases physical pain” can be found in the February 2016 issue of Psychological Science.