Article Text

Download PDFPDF

Original article
Effect of socioeconomic conditions on frequent complaints of pain in children: findings from the UK Millennium Cohort Study
  1. Benjamin Adam Fryer1,
  2. Gavin Cleary2,
  3. Sophie Louise Wickham1,
  4. Benjamin Richard Barr1,
  5. David Carlton Taylor-Robinson1
  1. 1 Department of Public Health and Policy, University of Liverpool, Liverpool, UK
  2. 2 Department of Rheumatology, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
  1. Correspondence to Benjamin Adam Fryer; ben.fryer{at}


Background Frequent complaints of pain (FCP) are common in high-income countries, affecting about 25% of children, and may have significant adverse consequences including prolonged school absence and disability. Most FCP are unexplained, and the aetiology is poorly understood. This study aimed to identify risk factors for FCP and explore how risk factors explain variation in pain reporting by childhood socioeconomic conditions (SECs).

Methods Analysis of the UK Millennium Cohort Study, including 8463 singleton children whose parents provided data throughout the study. At 11 years, mothers were asked whether their child frequently complains of pain. Risk ratios (RR) and 95% CIs for FCP were estimated using Poisson regression, according to maternal education. Other risk factors were explored to assess if they attenuated any association between FCP and SECs.

Results 32.3% of children frequently complained of pain. Children of mothers with no educational qualifications were more likely to have FCP than children of mothers with higher degrees (RR 2.06, 95% CI 1.64 to 2.59) and there was a clear gradient across the socioeconomic spectrum. Female sex, fruit consumption, childhood mental health and maternal health measures were associated with childhood FCP in univariable and multivariable analyses. Inclusion of these factors within the model attenuated the RR by 17% to 1.70 (95% CI 1.36 to 2.13).

Conclusion In this representative UK cohort, there was a significant excess of FCP reported in less advantaged children that was partially attenuated when accounting for indicators of parental and childhood mental health. Addressing these factors may partially reduce inequalities in childhood FCP.

  • Educational Status
  • Chronic Pain
  • Risk Factors
  • Longitudinal Study
  • Children

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

View Full Text

Statistics from


  • Contributors BF designed the study, analysed the data and drafted the manuscript. GC, SLW and DCTR provided input on the study design. SLW and DCTR contributed to the analytical strategy. GC, SLW, BRB and DCTR commented on drafts of the manuscript. All authors read and approved the final manuscript.

  • Funding SLW is supported by a Wellcome Trust research fellowship. This piece of work was also supported by The Farr Institute for Health Informatics Research (MRC grant: MR/M0501633/1). The Millennium Cohort Study is funded by grants to former and current directors of the study from the Economic and Social Research Council (Professor HeatherJoshi, Professor Lucinda Platt and Professor Emla Fitzsimons) and a consortium of government funders. All researchers were independent of the funders, and the funders played no part in the study design, analysis or interpretation of the data, writing of the report or the decision to submit for publication.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data used in this study are available from the UK data service.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.