Incidence and Progression Patterns of Chronic Pain Disparities Revealed by Analyzing the All of Us Research Program Data

Disparities in the progression of ten chronic overlapping pain conditions (COPC) and four comorbid mental disorders among traditionally underrepresented populations have rarely been reported in the literature. In this study, we conducted retrospective cohort analyses using All of Us Research Program data from 1981 to 2022 to address this issue. Separate cohorts were created to assess the disparities by sex, race, and ethnicity. Logistic regression models, controlling for demographic variables, were employed to identify significant disparity factors associated with the progression from one COPC or mental condition to another. Among 122 frequent disease pairs, we identified demographic disparities in nine progression pathways. For example, we found an increased likelihood of subsequent depression after irritable bowel syndrome in Hispanics versus non-Hispanic individuals (OR:3.13, p<10 ⁻¹⁰ ). To our knowledge, this is the first study to unveil demographic disparities in COPC progression. These findings underscore the importance of examining health disparities among individuals affected by multiple chronic pain conditions.