Pain and subjective well-being among older adults in the developing world : A comprehensive assessment based on the WHO Study on Global Ageing and Adult Health

Abstract

This paper studies the association of pain with subjective well-being (SWB) and time use among older adults in five low- and middle-income countries using data from the first wave of the WHO Study on Global Ageing and Adult Health. We suggest a novel use of anchoring vignettes as direct control functions to account for potentially correlated reporting behaviors such as correlated response scales when analyzing the relationship between subjective variables such as self-reported pain and SWB. Exploiting detailed data on individual time use and several complementary measures of SWB, including fine-grained activity-specific affective experiences derived from an abbreviated version of the Day Reconstruction Method, we find that both evaluative and experienced well-being are markedly lower for people living with pain compared to those without pain. These disparities persist even after controlling for possible confounding from reporting behaviors through the use of anchoring vignettes. Differences in experienced utility by pain status appear to be exclusively due to worse affective experiences during daily activities for those with pain, which seem to be partially mediated through changes in their functional limitations. Pain-related differences in time use, in turn, seem to provide only small compensating effects, underscoring important challenges to the use of changed activity patterns as a viable coping strategy for individuals enduring pain.