Chronic Pain and Subjective Health in a Sample of Indonesian Adults: A Moderation of Gender

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Pius Weraman
Nugroho Susanto
Luh Tu Selpi Wahyuni
Doni Pranata
Kundharu Saddhono
Komang Ayu Krisna Dewi
Kadek Lina Kurniawati
I Putu Agus Dharma Hita
Nyoman Ayu Putri Lestari
Emmanuel Nizeyumukiza


Chronic pain is an essential burden for public health. Yet, evidence of its association with subjective perceptions of health in the community and gender differences is still lacking in Indonesia. This study examined how chronic pain relates to subjective health in the community and gender differences in this relationship using an Indonesian nationwide community survey. A total of 3,255 adults were involved in the study, with the mean age of the participants being 41.6 years (SD = 13.4), with 57% identifying as female. The results revealed that chronic pain was an essential predictor of subjective health. Those who had chronic pain reported poor subjective health compared to their counterparts, regardless of their gender, education level, marital status, smoking status, unemployment status, religiosity, and extroversion personality trait. In addition, the findings showed that the negative association between chronic pain and subjective health was stronger in women than in men. This study stipulates that targeting pain in the general population and managing and treating pain might lead to improvement in public health. In addition, efforts to reduce chronic pain and to increase subjective health in the general population should be gender mindful.

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How to Cite
Weraman, P. ., Susanto, N., Wahyuni, L. T. S. ., Pranata, D. ., Saddhono, K. ., Dewi, K. A. K. ., Kurniawati, K. L. ., Hita, I. P. A. D. ., Lestari, N. A. P. ., & Nizeyumukiza, E. (2023). Chronic Pain and Subjective Health in a Sample of Indonesian Adults: A Moderation of Gender . Journal of Population and Social Studies [JPSS], 32, 278–289. Retrieved from
Research Articles
Author Biography

Nugroho Susanto, Padang State University, Indonesia

Corresponding author


• Aiken-Morgan, A. T., Bichsel, J., Savla, J., Edwards, C. L., & Whitfield, K. E. (2014). Associations between self-rated health and personality. Ethnicity and Disease, 24(4), 418–422.

• Alabas, O. A., Tashani, O. A., Tabasam, G., & Johnson, M. I. (2012). Gender role affects experimental pain responses: A systematic review with meta-analysis. European Journal of Pain, 16(9), 1211–1223.

• Asfar, T., Ahmad, B., Rastam, S., Mulloli, T. P., Ward, K. D., & Maziak, W. (2007). Self-rated health and its determinants among adults in Syria: A model from the Middle East. BMC Public Health, 7, Article 177.

• Azevedo, L. F., Costa-Pereira, A., Mendonça, L., Dias, C. C., & Castro-Lopes, J. M. (2012). Epidemiology of chronic pain: A population-based nationwide study on its prevalence, characteristics and associated disability in Portugal. Journal of Pain, 13(8), 773–783.

• Brattberg, G., Thorslund, M., & Wikman, A. (1989). The prevalence of pain in a general population. The results of a postal survey in a county of Sweden. Pain, 37(2), 215–222.

• Cairns, B. E., & Gazerani, P. (2009). Sex-related differences in pain. Maturitas, 63(4), 292–296.

• Crook, J., Rideout, E., & Browne, G. (1984). The prevalence of pain complaints in a general population. Pain, 18(3), 299–314.

• Damian, J., Ruigomez, A., Pastor, V., & Martin-Moreno, J. M. (1999). Determinants of self-assessed health among Spanish older people living at home. Journal of Epidemiology and Community Health, 53(7), 412–416.

• DeSalvo, K. B., Bloser, N., Reynolds, K., He, J., & Muntner, P. (2006). Mortality prediction with a single general self-rated health question: A meta-analysis. Journal of General Internal Medicine, 21(3), 267–275.

• Eder, D. (1985). The cycle of popularity : Interpersonal relations among female adolescents. Sociology of Education, 58(3), 154–165.

• Fillingim, R. B., King, C. D., Ribeiro-Dasilva, M. C., Rahim-Williams, B., & Riley, J. L. (2009). Sex, gender, and pain: A review of recent clinical and experimental findings. Journal of Pain, 10(5), 447–485.

• Gold, J. I., Yetwin, A. K., Mahrer, N. E., Carson, M. C., Griffin, A. T., Palmer, S. N., & Joseph, M. H. (2009). Pediatric chronic pain and health-related quality of life. Journal of Pediatric Nursing, 24(2), 141–150.

• Gozan, M. M., & Asih, S. R. (2021). How Indonesians cope with chronic pain: Does seeking help and comfort from God work? Psychological Research on Urban Society, 4(2), 38–51.

• Hartz, A., & Kirchdoerfer, E. (1987). Undetected fibrositis in primary care practice. Journal of Family Practice, 25(4), 365–369.

• Hita, I. P. A. D., Kushartanti, B. M. W., Ariestika, E., Widiyanto, & Nizeyumukiza, E. (2021). The association between physical activity and self-rated health among older adults. Journal of Population and Social Studies, 29, 450–458.

• Hooten, W. M. (2016). Chronic pain and mental health disorders: Shared neural mechanisms, epidemiology, and treatment. Mayo Clinic Proceedings, 91(7), 955–970.

• Idler, E. L., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38(1), 21–37.

• Jensen, H. I., Plesner, K., Kvorning, N., Krogh, B. L., & Kimper-Karl, A. (2016). Associations between demographics and health-related quality of life for chronic non-malignant pain patients treated at a multidisciplinary pain centre: A cohort study. International Journal for Quality in Health Care, 28(1), 86–91.

• Kawai, K., Kawai, A. T., Wollan, P., & Yawn, B. P. (2017). Adverse impacts of chronic pain on health-related quality of life, work productivity, depression and anxiety in a community-based study. Family Practice, 34(6), 656–661.

• Kööts-Ausmees, L., Schmidt, M., Esko, T., Metspalu, A., Allik, J., & Realo, A. (2016). The role of the five-factor personality traits in general self-rated health. European Journal of Personality, 30(5), 492–504.

• Kristianingrum, N. D., Wiarsih, W., & Nursasi, A. Y. (2018). Perceived family support among older persons in diabetes mellitus self-management. BMC Geriatrics, 18(Suppl 1), Article 304.

• Kroenke, K., Outcalt, S., Krebs, E., Bair, M. J., Wu, J., Chumbler, N., & Yu, Z. (2013). Association between anxiety, health-related quality of life and functional impairment in primary care patients with chronic pain. General Hospital Psychiatry, 35(4), 359–365.

• Langley, P. C., Ruiz-Iban, M. A., Molina, J. T., De Andres, J., & Castellón, J. R. G. E. (2011). The prevalence, correlates and treatment of pain in Spain. Journal of Medical Economics, 14(3), 367–380.

• Lietz, F., Piumatti, G., Marinkovic, J., & Bjegovic-Mikanovic, V. (2017). Correlates of self-rated health in southern Europe: Evidences from national representative samples in Italy and Serbia. Journal of Public Health (United Kingdom), 39(4), 745–753.

• Lukman, N. A., Leibing, A., & Merry, L. (2020). Self-care experiences of adults with chronic disease in Indonesia: An integrative review. International Journal of Chronic Diseases, 2020, Article 1379547.

• Mäntyselkä, P., Kumpusalo, E., Ahonen, R., Kumpusalo, A., Kauhanen, J., Viinamäki, H., Halonen, P., & Takala, J. (2001). Pain as a reason to visit the doctor: A study in Finnish primary health care. Pain, 89(2–3), 175–180.

• Mäntyselkä, P. T., Turunen, J. H. O., Ahonen, R. S., Kumpusalo, E. A., & Brown, M. M. (2004). Chronic pain and poor self-rated health. Evidence-Based Eye Care, 5(2), 110–111.

• McDonald, M., Dibonaventura, M. D., & Ullman, S. (2011). Musculoskeletal pain in the workforce: The effects of back, arthritis, and fibromyalgia pain on quality of life and work productivity. Journal of Occupational and Environmental Medicine, 53(7), 765–770.

• Ministry of Health [Indonesia]. (2018, November 2). Hasil Utama Riskesdas 2018 [Main Results of Riskesdas 2018]. Directorate General of Public Health, Ministry of Health.

• Mohamed Zaki, L. R., & Hairi, N. N. (2015). A systematic review of the prevalence and measurement of chronic pain in Asian adults. Pain Management Nursing, 16(3), 440–452.

• Mossey, J. M., & Shapiro, E. (1982). Self-rated health: A predictor of mortality among the elderly. American Journal of Public Health, 72(8), 800–808.

• Myers, C., Riley, J. L., & Robinson, M. E. (2003). Psychosocial contributions to sex-correlated differences in pain. The Clinical Journal of Pain, 19(4), 225–232.

• Nayak, S., Hubbard, A., Sidney, S., & Syme, S. L. (2018). A recursive partitioning approach to investigating correlates of self-rated health: The CARDIA Study. SSM - Population Health, 4, 178–188.

• Nizeyumukiza, E., Cilik Pierewan, A., Ndayambaje, E., & Ayriza, Y. (2020). Trust and well-being: Evidence from Indonesia. Asian Social Work and Policy Review, 14(3), 148–157.

• Nolen-Hoeksema, S. (2012). Emotion regulation and psychopathology: The role of gender. Annual Review of Clinical Psychology, 8, 161–187.

• Nolen-Hoeksema, S., & Aldao, A. (2011). Gender and age differences in emotion regulation strategies and their relationship to depressive symptoms. Personality and Individual Differences, 51(6), 704–708.

• Norman, G. (2010). Likert scales, levels of measurement and the “laws” of statistics. Advances in Health Sciences Education, 15(5), 625–632.

• Ojeda, B., Salazar, A., Dueñas, M., Torres, L. M., Micó, J. A., & Failde, I. (2014). The impact of chronic pain: The perspective of patients, relatives, and caregivers. Families, Systems and Health, 32(4), 399–407.

• Posit Software. (2023). RStudio (RSTUDIO-2023.09.1-494) [Software].

• Potter, R. (1990). The frequency of presentation of pain. An analysis of 1000 consecutive consultations. Pain Society, 8, 11–14.

• Rahmawati, R., & Bajorek, B. (2018). Understanding untreated hypertension from patients’ point of view: A qualitative study in rural Yogyakarta province, Indonesia. Chronic Illness, 14(3), 228–240.

• Rammstedt, B., & John, O. P. (2007). Measuring personality in one minute or less : A 10-item short version of the Big Five Inventory in English and German. Journal of Research in Personality, 41, 203–212.

• Réthelyi, J. M., Berghammer, R., & Kopp, M. S. (2001). Comorbidity of pain-associated disability and depressive symptoms in connection with sociodemographic variables: Results from a cross-sectional epidemiological survey in Hungary. Pain, 93(2), 115–121.

• Reyes-Gibby, C. C., Aday, L. A., & Cleeland, C. (2002). Impact of pain on self-rated health in the community-dwelling older adults. Pain, 95(1–2), 75–82.

• Samulowitz, A., Gremyr, I., Eriksson, E., & Hensing, G. (2018). “Brave men” and “emotional women”: A theory-guided literature review on gender bias in health care and gendered norms towards patients with chronic pain. Pain Research and Management, 2018, Article 6358624.

• Sari, S. A. A. Y., Indarto, D., & Wijaya, M. (2018). Application of Health Belief Model on preventive behaviors of patients with low back pain. Journal of Health Promotion and Behavior, 3(3), 192–198.

• Smith, B. H., Elliott, A. M., Alastair Chambers, W., Smith, W. C., Hannaford, P. C., & Penny, K. (2001). The impact of chronic pain in the community. Family Practice, 18(3), 292–299.

• Strauss, J., Witoelar, F., & Sikoki, B. (2016, March 31). User’s Guide for the Indonesia Family Life Survey, Wave 5: Volume 2.

• Stubbs, D. W., Krebs, E., Bair, M., Damush, T., Wu, J., Sutherland, J., & Kroenke, K. (2010). Sex differences in pain and pain-related disability among primary care patients with chronic musculoskeletal pain. Pain Medicine, 11(2), 232–239.

• Svedberg, P., Bardage, C., Sandin, S., & Pedersen, N. L. (2006). A prospective study of health, life-style and psychosocial predictors of self-rated health. European Journal of Epidemiology, 21(10), 767–776.

• Tsai, M. C., Lin, S. H., Chou, Y. Y., & Lin, S. J. (2014). Exploration of health status, healthcare utilization, and health service expectations among Taiwanese adolescents. European Journal of Pediatrics, 173(2), 187–196.

• Unruh, A. M. (1996). Gender variations in clinical pain experience. Pain, 65(2–3), 123–167.

• Wuorela, M., Lavonius, S., Salminen, M., Vahlberg, T., Viitanen, M., & Viikari, L. (2020). Self-rated health and objective health status as predictors of all-cause mortality among older people: A prospective study with a 5-, 10-, and 27-year follow-up. BMC Geriatrics, 20(1), Article 120.

• Yiengprugsawan, V. S., Piggott, J., Witoelar, F., Blyth, F. M., & Cumming, R. G. (2020). Pain and its impact on functional health: 7-year longitudinal findings among middle-aged and older adults in Indonesia. Geriatrics (Switzerland), 5(2), Article 39.

• Zondervan, K. T., Yudkin, P. L., Vessey, M. P., Dawes, M. G., Barlow, D. H., & Kennedy, S. H. (1999). Prevalence and incidence of chronic pelvic pain in primary care: Evidence from a national general practice database. BJOG: An International Journal of Obstetrics and Gynaecology, 106(11), 1149–1155.