Most people who visit the emergency room report some kind of physical pain. Although pain is usually regarded as a physical issue, recent research has started to study pain from a much broader perspective. Indeed, pain has been found to be linked to socioeconomic factors like income, education, and employment, psychological states like stress, and a wide range of behaviors like drug use and generosity.

Research has documented that what matters for one's well-being is how much more or less a person has in comparison to others instead of how much money a person actually earns. This happens because humans tend to naturally compare themselves with similar people, for example, those who live in the same country, have the same degree, work in the same place, or even do the same tasks at work.

Social Comparisons and Pain

In one of my recent studies, I explored whether having less than others is likely to create physical pain. The data came from the Gallup World Poll and involved 1.3 million respondents from 146 countries worldwide. Respondents were asked whether they experienced physical pain the day before. In line with the idea that people care about whether their income is the highest or lowest in their comparison group, I found that people whose income ranked lower in their reference group reported greater physical pain than those whose income ranked higher.

One could think that what people actually earned was driving the link between income rank and pain because those with lower income rank also had a low level of income. To untangle this, I then took into account people's absolute level of income. The main findings held: People's relative standing in the income hierarchy mattered more for physical pain than the number of dollars earned.

What could explain these findings? It is well known that people suffer when they are worse off in comparison to a certain standard or comparison group. This means that if I have a lower income than you, I will suffer regardless of whether the income I earn allows me to have a great lifestyle. Research has documented that being relatively worse off can lead to negative feelings like envy, injustice, anger, and resentment. At the same time, neuroscientists have discovered that negative emotions and physical pain share the same brain mechanisms, proposing that negative emotions can create new pain. Having less than others may lead to negative feelings which could create physical pain.

In Both Rich and Poor Nations

I explored whether the link between pain and income differed among rich and poor populations in the world. According to standard economic reasoning, having low income should be more painful in poor than in rich countries. This is because the income of individuals at the bottom of the income distribution in poor countries is much lower than the income of those at the bottom of the income distribution in rich countries. I found the opposite. The link between income, both absolute and rank, and pain was the same across rich and poor nations. This suggests that it doesn't matter where you live: if you live in a poor country and are surrounded by poorer people you will be better off than someone who lives in a rich country and is surrounded by richer people.  

In the Workplace Too?

The role of relative income in well-being, including pain, can be found in everyday life and has particularly important consequences in the workplace. For instance, in an attempt to deal with the negative feelings that arise from having less income than others, employees may compete with their colleagues to climb the salary ladder. This competition may create a hostile working environment with negative consequences like lower job satisfaction and resignation. Employees' greater pain can also have important financial implications as pain has been found to be a key predictor of absenteeism and turnover: When those at the bottom of the salary hierarchy in the comparison group experience greater pain, the number of sick days and absenteeism rates are likely to increase.

Although pain can obviously be the consequence of a physical issue, pain can also be influenced by psychological factors. Indeed, this research uncovers that a well-known psychological aspect, namely social comparison, might have important consequences for people's pain. In a world in which the percentage of people in pain has been rising dramatically, knowing more about the determinants of pain has become increasingly relevant. Organizational leaders, scientists, and policymakers have now extra reasons to tackle inequalities to improve people's pain and overall well-being.

For Further Reading

Macchia, L. (2023). Having less than others is painful: Income rank and pain around the world. Social Psychological and Personality Science. Doi:

Lucia Macchia is a behavioral scientist with an interdisciplinary background. Her work involves quantitative research on human happiness, physical pain, and behavior. She is a Lecturer at City, University of London and a Visiting Fellow in the Department of Psychological and Behavioural Science at the London School of Economics.