Pain and 56 Subsequent Wellbeing and Life Outcomes: An Outcome-Wide Longitudinal Approach in a Multi-Country Sample

Pain is a universal problem, with millions of people around the world experiencing some kind of pain. Despite its importance, rigorous longitudinal evidence on the longer-term effects of pain across various countries remains scarce. This study takes one step toward addressing this gap by examining how pain predicts 56 diverse wellbeing and life-related outcomes using longitudinal data from 22 countries and one territory (N = 207,989). Country-specific regression analyses were conducted, with estimates pooled using random-effects meta-analyses. Adjusting for demographic and childhood factors, we find that pain in Wave 1 negatively predicts flourishing, happiness, life satisfaction, inner peace, mental health, purpose, relationship satisfaction, belonging, orientation to promote good, delayed gratification, hope, gratitude, showing love, physical health, physical exercise, financial and material security, financial comfort, owning home, and being in the top income quintile in Wave 2. Conversely, pain in Wave 1 significantly predicts higher traumatic distress, anxiety, depression, suffering, loneliness, perceived discrimination, health problems, and pain in Wave 2. Pain in Wave 1 has the largest positive effects on subsequent pain, health problems, and suffering, and the largest negative effects on subsequent secure flourishing, mental health, and financial security. This study offers some of the most comprehensive country-wide evidence to date on the potential enduring impact of pain, providing valuable insights for policymakers, healthcare providers, and global organizations focused on reducing health inequalities and enhancing human wellbeing.