All ETDs from UAB

Advisory Committee Chair

David Schwebel

Advisory Committee Members

Burel Goodin

Emily Wakefield

Document Type


Date of Award


Degree Name by School

Master of Arts (MA) College of Arts and Sciences


Background: Low socioeconomic status (SES) may exacerbate pain and impede functioning in children with chronic widespread pain. SES can be categorized as objective or subjective and assessed at individual, family, and neighborhood levels. However, most studies do not assess SES this comprehensively, thus, the true impact of SES on child health is likely unknown. The proposed study examined the unique and interactive effects of different measures of SES on pain severity and functioning in children with rheumatic conditions including juvenile idiopathic arthritis (JIA), juvenile primary fibromyalgia syndrome (JPFS), and non-specific musculoskeletal pain (NSMP). Methods: 88 children (32 JIA, 31 JPFS, 25 NSMP) between the ages of 8 and 18 and their caregivers were recruited from a rheumatology clinic. Objective neighborhood-level and subjective individual-level indicators of SES were obtained from parents using the childhood opportunity index (COI) and caregiver reported MacArthur Scale of Subjective Social Status (Caregiver SSS), respectively. In addition to a composite COI score, child-hood opportunity was examined via its three subdomains (i.e., Health & Environment, Education, and Social & Economic). Children reported their pain interference, pain intensity, and physical and psychosocial functioning. Results: Findings on the relationship between SES and pain and functioning were mixed. Total COI was not significantly associated with any of the pain variables, nor did it significantly interact with family SES. However, the Social & Economic domain of COI moderated the relationship between family SES and pain intensity, such that greater family SES was positively associated with greater pain intensity in children from low COI neighborhoods. While greater COI was associated with poorer physical functioning, greater caregiver SSS was associated with greater physical functioning. Caregiver SSS was not significantly associated with any other pain-related variables and did not interact with family SES on pain nor functioning. Conclusion: While subjective SES is associated with greater functioning, objective SES is associated with worse functioning and pain. The results of this study highlight the importance of examining SES multidimensionally. Future studies should consider caregiver stress, social support, and caregiver pain responses as potential contributors to functioning in children with rheumatic pain.



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