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Introduction <p>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.</p> Methods <p>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.</p> Results <p>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.</p> Conclusions <p>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.</p>

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

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月16日

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  • Asa B. Smith,
  • Amelia Knopf,
  • Yehui Zhu,
  • Katelyn E. Webster-Dekker,
  • Scott Emory Moore,
  • Selena Wang,
  • Kelly L. Wierenga

摘要

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.