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Mental & Physical Health20255 min read

The Long Shadow of a Painful Childhood

A cross-national analysis of childhood predictors of physical pain

Notable finding

Childhood abuse is linked to a 25% higher risk of adult pain.

By
Macchia, Lucía et al.
Participants
202,898
Countries
22
Journal
Communications Medicine
DOI
10.1038/s43856-025-00997-2
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§1

Key Takeaways

01

Adverse childhood experiences, such as parental divorce, family financial hardship, abuse, and poor health, are linked to a greater risk of experiencing physical pain in adulthood.

02

The strength of the connection between childhood circumstances and adult physical pain varies significantly across different countries and cultures.

03

More frequent religious service attendance at age 12 was associated with a greater risk of experiencing physical pain later in life.

§2

Why It Matters

The fight against chronic pain begins not in the doctor's office, but in policies that create stable and nurturing childhoods.

This research matters because it connects two urgent issues: childhood adversity and the global rise in chronic pain. By showing that childhood experiences like abuse, financial struggle, and feeling like an outsider are tied to adult pain across many different cultures, the study points to a clear opportunity for early intervention. If doctors, schools, and policymakers can better support children facing these hardships, they may help reduce pain that could otherwise last a lifetime. The finding that abuse predicted pain in all 22 countries is especially powerful, underscoring that protecting children from harm is not just a moral imperative but a public health one. The cross-country differences also remind us that no single solution fits every nation, and that local context shapes how childhood experiences unfold over a lifetime.

This research matters because it connects two urgent issues: childhood adversity and the global rise in chronic pain. By showing that childhood experiences like abuse, financial struggle, and feeling like an outsider are tied to adult pain across many different cultures, the study points to a clear opportunity for early intervention. If doctors, schools, and policymakers can better support children facing these hardships, they may help reduce pain that could otherwise last a lifetime. The finding that abuse predicted pain in all 22 countries is especially powerful, underscoring that protecting children from harm is not just a moral imperative but a public health one. The cross-country differences also remind us that no single solution fits every nation, and that local context shapes how childhood experiences unfold over a lifetime.

The fight against chronic pain begins not in the doctor's office, but in policies that create stable and nurturing childhoods.

§3

The Story

Researchers asked a simple but powerful question: do things that happen in childhood predict how much physical pain people experience as adults? To find out, they surveyed over 200,000 people across 22 countries, asking them to look back at their early lives. They explored 13 different childhood factors, including family income, relationships with parents, abuse, health, and even how often they attended religious services at age 12.

The aches and pains we feel as adults can be echoes of childhood stress, our bodies carrying the memory of early hardship.

The results were striking. People who experienced abuse as children had a 25% higher risk of adult pain, and this pattern showed up in every single one of the 22 countries studied. Those who felt like outsiders in their own families, whose parents had divorced or died, or whose families struggled financially also reported more pain later in life. Poor health during childhood was another strong predictor.

Surprisingly, people who attended religious services more often at age 12 also tended to report more adult pain, though the researchers note this may be because children with health problems sought comfort in religion. The study also found that the strength of these connections varied from country to country, suggesting that local culture, safety nets, and history all play a role in how childhood hardship translates into adult pain.

Figure
+25%
Increased Pain from Abuse

Adults who experienced physical or sexual abuse during childhood had a 25% greater risk of experiencing physical pain compared to those who were not abused.

Figure
1.2x
Poor Childhood Health

Adults who reported having poor physical health while growing up had a 1.2 times greater risk of experiencing pain compared to those with good childhood health.

Figure
+16%
Pain Risk from Isolation

People who felt like an outsider in their family while growing up had a 16% greater risk of experiencing physical pain in adulthood.

Figure
1.11x
Impact of Single Parent

Individuals who grew up with a single, never-married parent had a 1.11 times greater risk of experiencing physical pain in adulthood compared to those whose parents were married.

Figures
+25%
Increased Pain from Abuse

Adults who experienced physical or sexual abuse during childhood had a 25% greater risk of experiencing physical pain compared to those who were not abused.

1.2x
Poor Childhood Health

Adults who reported having poor physical health while growing up had a 1.2 times greater risk of experiencing pain compared to those with good childhood health.

+16%
Pain Risk from Isolation

People who felt like an outsider in their family while growing up had a 16% greater risk of experiencing physical pain in adulthood.

1.11x
Impact of Single Parent

Individuals who grew up with a single, never-married parent had a 1.11 times greater risk of experiencing physical pain in adulthood compared to those whose parents were married.

§4

Reader Questions

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Research Details
& Citation

Chat with this paper
Published
2025
Journal
Communications Medicine
Participants
202,898
Countries
22
Cite this paper
Macchia, L., Okafor, C. N., Breedlove, T., Shiba, K., Piper, A., Johnson, B., & VanderWeele, T. J. (2025). A cross-national analysis of childhood predictors of physical pain. Communications Medicine, 5(1). https://doi.org/10.1038/s43856-025-00997-2
Tags
painphysical-healthchildhoodrelationship-qualityfinancial-wellbeingreligion-spirituality
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