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Mental & Physical Health20258 min read

The Global Map of Human Suffering

A cross-national analysis of sociodemographic variation in suffering across 22 countries

Notable finding

In Türkiye, 60% of the population reports experiencing suffering.

By
Cowden, Richard G. et al.
Participants
202,898
Countries
22
Journal
Communications Medicine
DOI
10.1038/s43856-025-00859-x
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§1

Key Takeaways

01

The proportion of people experiencing significant suffering varies considerably across countries, with rates in the highest-suffering nation, Türkiye, being more than double those in the lowest-suffering nation, Poland.

02

Across all 22 nations, people who are separated from their spouse, unemployed, or have eight or fewer years of education consistently report the highest levels of suffering.

03

While some sociodemographic patterns are consistent, the specific groups most vulnerable to suffering often differ from one country to another, indicating that local context is important.

§2

Why It Matters

This research matters because it gives us the first large-scale, nationally representative picture of suffering across diverse countries. Before this study, most research on suffering came from clinical settings in Western countries — patients with terminal illness, older adults, or people with chronic conditions. This study broadens the lens to everyday people in 22 nations, from Tanzania to Sweden to Brazil.

Tracking suffering like a disease reveals how social and economic forces shape our deepest forms of distress.

The findings point to specific groups who may be especially vulnerable: people going through marital separation, those without stable employment, and those with very little formal education. These are groups that public health systems, social services, and policymakers can identify and support. For example, programs that combine adult education with job placement, or that provide targeted mental health resources during separation, could reach people at higher risk of suffering.

The study also shows that suffering is not the same as depression or pain — countries ranked differently on suffering than on depression symptoms, suggesting suffering is a distinct experience that deserves its own attention. As future waves of data arrive, researchers will be able to track how suffering changes over time and whether interventions are working. For now, this study lays the groundwork for a global public health agenda that takes suffering seriously — not just as a symptom of something else, but as a human experience worth measuring, understanding, and addressing directly.

This research matters because it gives us the first large-scale, nationally representative picture of suffering across diverse countries. Before this study, most research on suffering came from clinical settings in Western countries — patients with terminal illness, older adults, or people with chronic conditions. This study broadens the lens to everyday people in 22 nations, from Tanzania to Sweden to Brazil. The findings point to specific groups who may be especially vulnerable: people going through marital separation, those without stable employment, and those with very little formal education. These are groups that public health systems, social services, and policymakers can identify and support. For example, programs that combine adult education with job placement, or that provide targeted mental health resources during separation, could reach people at higher risk of suffering. The study also shows that suffering is not the same as depression or pain — countries ranked differently on suffering than on depression symptoms, suggesting suffering is a distinct experience that deserves its own attention. As future waves of data arrive, researchers will be able to track how suffering changes over time and whether interventions are working. For now, this study lays the groundwork for a global public health agenda that takes suffering seriously — not just as a symptom of something else, but as a human experience worth measuring, understanding, and addressing directly.

Tracking suffering like a disease reveals how social and economic forces shape our deepest forms of distress.

§3

The Story

Suffering is something every human knows, but how much it touches a population varies enormously around the world. This study asked over 200,000 people across 22 countries a simple question: 'To what extent are you suffering?' The answers ranged widely.

Across the globe, instability in our jobs, relationships, and opportunities can cause a deep and personal pain.

In Türkiye, 60% of people said they were suffering at least 'some' or 'a lot.' In Poland, only 24% said the same. That means suffering was more than twice as common in one country compared to another. But the study didn't just look at countries.

It also asked who, within each country, was most likely to suffer. When researchers pooled results across all 22 nations, three patterns stood out. People who had separated from their spouse reported the highest suffering — 56% said they were suffering, compared to 41% of married people. Those who were unemployed and looking for work, or who fell into an 'other' employment category, also reported more suffering than people employed by an employer. And people with eight or fewer years of education reported more suffering than those with 16 or more years.

Interestingly, some differences you might expect didn't show up when averaged across countries. Age, gender, immigration status, and how often someone attended religious services didn't produce clear overall gaps in suffering — though in individual countries, some of these mattered a lot. For example, in 17 of the 22 countries, women reported more suffering than men, but the size of that gap varied widely. The study also found that no single pattern applied everywhere. In some countries, people who attended religious services most often had the lowest suffering. In others, the same group had the highest. This suggests that suffering is shaped not just by personal circumstances, but by the cultural and social context in which people live. These findings offer a first-of-its-kind map of suffering across the globe — and a starting point for identifying who may need the most support.

Figure
60%
Suffering in Türkiye

Türkiye had the highest proportion of people reporting some or a lot of suffering, with 60% of its population endorsing this experience.

Figure
2.5x
Cross-National Suffering Disparity

The rate of suffering in Türkiye, the country with the highest proportion, was 2.5 times greater than in Poland, the country with the lowest proportion.

Figure
54%
Unemployment and Suffering

Across 22 countries, 54% of people who were unemployed and looking for a job reported experiencing some or a lot of suffering.

Figure
+9 points
Education Level Disparity

Individuals with 8 or fewer years of education were 9 percentage points more likely to report suffering compared to those with 16 or more years of education.

Figures
60%
Suffering in Türkiye

Türkiye had the highest proportion of people reporting some or a lot of suffering, with 60% of its population endorsing this experience.

2.5x
Cross-National Suffering Disparity

The rate of suffering in Türkiye, the country with the highest proportion, was 2.5 times greater than in Poland, the country with the lowest proportion.

54%
Unemployment and Suffering

Across 22 countries, 54% of people who were unemployed and looking for a job reported experiencing some or a lot of suffering.

+9 points
Education Level Disparity

Individuals with 8 or fewer years of education were 9 percentage points more likely to report suffering compared to those with 16 or more years of education.

§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
Cowden, R. G., Chen, Z. J., Wilkinson, R., Weziak-Bialowolska, D., Breedlove, T., Gundersen, C., Shiba, K., Padgett, R. N., Johnson, B. R., & VanderWeele, T. J. (2025). A cross-national analysis of sociodemographic variation in suffering across 22 countries. Communications Medicine, 5(1). https://doi.org/10.1038/s43856-025-00859-x
Tags
sufferingpainrelationship-qualityemploymenteducationinequality
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