Impact of Chronic Pain on the Families of U.S. Adults

Chronic pain (CP) can profoundly strain family systems, yet few population studies have explored CP with high impact on families. We used 2023 National Health Interview Survey Data (n=29,522) to characterize CP with high impact on families of U.S. adults. Findings are: (1) the prevalence of CP with high impact on families (HICP-Family) is 4.4% in U.S. adults and 18.1% in U.S. adults with CP; (2) HICP-Family is almost exclusively reported by those who have high impact chronic pain (HICP) that limits their individual functioning in life and work; (3) yet, among those with HICP, not all (46.3%) report HICP-Family; (4) HICP-Family can feasibly be modeled as a latter transition stage in a tiered cascade of advancing CP-associated impacts; (5) there is a strong association between clinically significant mental health symptoms and HICP-Family; HICP-Family is six times more prevalent among those who screen positive for moderate-to-severe anxiety or depression symptoms. Families highly impacted by CP may not be adequately resourced for adaptive functional resilience. HICP-Family may form an underappreciated barrier to achieving optimal pain and mental health outcomes for people with HICP. Further, without intervention, members of families highly impacted by CP may face heightened susceptibility to onset of suboptimal pain and mental health trajectories of their own. The need to develop effective supports and promote adaptive resilience in families highly impacted by CP is clear. Clinical tools to support person-centered assessment of family and relational functioning, effective family-level interventions, and innovative models of care are needed.