Caring for Depression and Comorbid Pain

Evidence from the Health and Retirement Survey and the Healthcare for Communities Survey

by Haijun Tian

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Depression that occurs along with painful physical symptoms has not been fully understood. Serious investigation into the interaction of depression and pain and its impact on the labor market, disability, and on financial aspects of health insurance and medication costs among Americans ages 55 to 65 is long overdue. This study found that depression and comorbid pain is associated with worse labor markets and worse financial, insurance, and disability outcomes compared to depression alone; and found that these adverse effects were attributed disproportionally to individuals whose depression included comorbid pain. Those individuals were less likely to take antidepressants, and pain comorbidity was associated with a heavier burden on total medication costs and prescription drug costs. Moreover, depression along with comorbid pain predicted early retirement for female workers, whereas depression alone did not predict early retirement for male or female workers. This study furthers the understanding of depression and pain comorbidity in terms of its prevalence in the general population and its effect on treatment and access to care.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Labor Market, Financial, Insurance and Disability Outcomes Among Near Elderly Americans with Depression and Pain: A National Study

  • Chapter Three

    Medication Behavior and Medication Costs Among Americans with depression and pain

  • Chapter Four

    Effect of Depression and Comorbid Pain on Retirement: Gender Differences

  • Chapter Five

    Discussion and Conclusions

Research conducted by

This document was submitted as a dissertation in March, 2006 in partial fulfillment of the requirements of the doctoral degree in public policy analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Richard Buddin (Chair), Emmett Keeler, Roland Sturm, and Cathy Sherbourne.

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