how your income determines how much pain you are in

Being poor not only hurts the wallet, but also literally causes physical pain, or at least that is how people experience that they are poorer than their environment. It does not matter whether you live in a poor or a rich country, according to a British study.

It is about the relative income compared to that of others. So suppose you now live in Blaricum and everyone around you lives in an expensive villa while you are in an outdated flat, then you will experience more pain than your wealthier neighbors, is the idea.

High on the ranking
The researchers of the University of London used an income ranking as a benchmark. People were classified according to their absolute personal income. The higher your position on the list, the higher your income compared to your peers, i.e. people who are very similar to you. That position affects how much pain you have. The following applies: the lower you are on that income list, the greater the chance that you will experience physical pain. And regardless of whether a person lived in a rich country or in a poor country, that connection remained. It is the first time that such a relationship between income and pain could be demonstrated.

The most surprising thing is that poor people in poor countries do not experience more pain than poor people in rich countries. You would expect personal income in poor countries to have a much greater effect on the experience of pain, as poor people can buy things that significantly improve their well-being when their income rises, while in rich countries these are already available to everyone, including for the poor. Follow-up research will therefore examine this in more detail, says researcher Dr. Lucía Macchia.

Pain, yes or no?
The British researchers analyzed data from 2009 to 2018 from the large annual World Gallup Poll (GWP). They had data on some 1.3 million people from 146 countries. Respondents were asked what the gross monthly income of their household was. That amount was divided by the number of people in the household to arrive at a personal income. The participants were also asked if they had experienced physical pain in the day before completing the questionnaire. They could tick yes or no.

Chronic pain
For people who do not have pain, this seems obvious, but 20 percent of the Dutch live with chronic pain. This is pain that lasts longer than three to six months. In recent decades, the number of people experiencing physical pain has increased dramatically, the researchers say. It affects everything from leisure time to productivity at work. It drives up healthcare costs and is therefore a major challenge for healthcare. Pain also plays a key role in suicide and in drug and alcohol abuse. Because it is so disruptive, it is important to understand the context of pain in order to improve conditions. For example, previous research has already shown that pain is subjective: after a failed operation, patients experience more pain than when the same operation was successful. You also experience more pain with a bad mood.

Social comparison
It has now also been shown that your income makes a difference compared to that of others. “This is the first study to prove that income and pain are linked around the world. It seems that psychological factors related to social comparison influence the physical pain that someone experiences,” explains researcher Lucía Macchia.

She thinks that the explanation for the relationship between pain and income must be sought in negative emotions that arise from (the lack of) appreciation of one’s own income position compared to that of peers. In addition, social comparison also plays a role, which says more about your position and status in society and the feeling that social mobility is lacking, so that it is difficult to acquire a higher position on the social ladder.

Difference from peers
In this study, only a relationship has been explicitly demonstrated, not a causal relationship. What makes it strong is that it is about a relative difference with peers, i.e. similar people. The explanation that poorer people, for example, are more often chronically ill and therefore experience more pain is thus removed: relatively wealthy people also experience more pain than their even wealthier peers.