Relationship between chronic pain and psychological distress among immigrants: Mediated by life satisfaction and moderated by sexual identity

Authors

• D Adzrago
• F Williams

Abstract

Background: Chronic pain and lower life satisfaction significantly impact psychological distress (PD). However, no study has examined whether chronic pain influences PD through life satisfaction among immigrant subgroups, including sexual identities. We investigated the mediation effects of life satisfaction, moderated by sexual identity, on the relationship between chronic pain and PD among adult immigrants in the US.

Methods: We analyzed the 2021 cross-sectional National Health Interview Survey data. Using the adult (aged >18 years) immigrant sample (n= 4,925), we computed mediation and moderated mediation analyses with multiple linear regression and bootstrapping.

Results: In the general immigrant population, the indirect effect (β= 0.26, p< 0.001) of chronic pain on PD was significantly positive. Life satisfaction mediated 21% of the total effect of chronic pain on PD. Sexual identity did not moderate the mediating effects of life satisfaction.
In the sexual minority population (i.e., gay/lesbian, bisexual, and others), the indirect effect (β= 0.47, p<0.05) was significantly positive. Life satisfaction mediated 56.40% of the total effect of chronic pain on PD. In the non-sexual minority population (i.e., heterosexual), the indirect effect (β= 0.23, p< 0.001) of chronic pain on PD were positive. Life satisfaction mediated 19% of the total effect of chronic pain on PD.

Conclusions: Life satisfaction mediates the effect of chronic pain on PD among immigrants, especially sexual minority individuals. Public health strategies aimed at reducing mental health disparities may need to consider the intersections of sexual identity, chronic pain, life satisfaction, and PD among immigrants.

Scientific Focus Area: Epidemiology

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