371 Journal of Rehabilitation Research and Development Vol. 40, No. 5, September/October 2003 Pages 371–380 Veterans’ reports of pain and associations with ratings of health, health-risk behaviors, affective distress, and use of the healthcare system Robert D. Kerns, PhD; John Otis, PhD; Roberta Rosenberg, MS; M. Carrington Reid, MD, PhD Department of Veterans Affairs (VA) Connecticut Healthcare System, West Haven, CT, and Yale University, New Haven CT; VA Boston Healthcare System, Boston, MA; Pfizer Incorporated, Groton, CT; Cornell Medical College, New York, NY Abstract—The improved management of pain among veterans seeking care in Veterans Health Administration (VHA) facili- ties has been established as a priority. This study documents the high prevalence of reports of pain among a convenience sample of 685 veterans seeking care in a VHA primary care setting. Also reported are associations of pain complaints with self-rated health, an index of emotional distress, health-risk behaviors such as tobacco and alcohol use, health-related con- cerns about diet and weight, and perceptions of the availability of social support. The relationship between the presence of pain and use of outpatient and inpatient medical and mental health services is also examined. Nearly 50% of the sample reported that they experience pain regularly and that they were concerned about this problem at the time of the index visit to their primary care provider. Persons acknowledging the pres- ence of pain, relative to those not reporting pain, were younger, reported worsening health over the past year, had greater emo- tional distress, used tobacco, had diet and/or weight concerns, and were found to use more outpatient medical, but not inpa- tient medical or mental health services. Results support the goals of the VHA National Pain Management Strategy designed to reduce unnecessary pain and suffering among vet- erans receiving care in VHA facilities. Key words: emotional distress, health-risk behaviors, health services use, pain, primary care. INTRODUCTION Pain has been identified as among the most frequent presenting complaints to healthcare providers, including those responsible for providing primary care [1,2]. Low back pain alone affects about 80 percent of the U.S. population at some point in life [3], and most persons with low back pain have their primary care providers manage their pain [4]. Turk and Melzack have cited com- pelling data about the enormous scope and costs associ- ated with pain and its management [5]. These scholars note that pain accounts for over 80 percent of all office visits to physicians each year! Data from epidemiological studies note that 37 percent of patients enrolled in a health Abbreviations: FY = fiscal year, HRBSQ = Health Risk Behavior Screening Questionnaire, SD = standard deviation, VA = Department of Veterans Affairs, VHA = Veterans Health Administration. This material was based on work supported by a merit grant from the Department of Veterans Affairs, Veterans Health Administration Office of Research and Develop- ment, Medical Research Service. Address all correspondence and requests for reprints to Robert D. Kerns, PhD; Psychology Service (116B), VA Connecticut Healthcare System, West Haven, CT 06516; 203-937-3841; fax: 203-937-4951; email: robert.kerns@med.va.gov.