Educational Disparities in Chronic Pain and Life Expectancy: Gaps and Pathways

Chronic pain is a debilitating and costly health condition that affects a large number of
people in the United States. The distribution of chronic pain is not universal in the population,
with less educated individuals disproportionately suffering from chronic pain and bearing related
adverse health consequences. This dissertation aims to provide evidence on the full causal chain
between education, chronic pain, and mortality. In the second chapter, the association between
education and different types of chronic pain is investigated. Moreover, mediation analyses are
performed to unveil the factors that underlie the association. In the third chapter, the influence of
chronic pain on certain health-compromising behaviors that are known to have an enormous
impact on life expectancy is explored. Using a matching technique, this chapter distinguishes
itself from prior studies by arguing for a causal relationship between chronic pain and changes in
health behaviors. While the aforementioned causal chain may be indirectly inferred from the
above two chapters, the fourth chapter directly tests the relationship using survival analyses and,
through a multivariable mediation analysis method, quantifies the unique contribution of chronic
pain to educational gradients in life expectancy. The datasets used in this dissertation come from
the National Health Interview Survey (NHIS) (for chapter two) and the Health and Retirement
Study (HRS) (for chapter three and four).