Towards a socio-ecological perspective of the “biopsychosocial model of pain”: Delineation of pathways between perceived pain intensity, community capital and mental distress among community-dwelling individuals

According to the “biopsychosocial model of pain”, pain can lead to significant effects on mental distress. However, previous studies have not linked this model to a socio-ecological perspective, although it is generally assumed that a supportive neighborhood environment can improve mental well-being. In particular, it is unclear how the built and social environment can be considered as community capital to improve the perceived quality of social and health services and support community-dwelling individuals. Following the “Community Capitals Framework” and the “Transdisciplinary Neighborhood Health Framework”, this study considered the perceived quality of urban amenities and their satisfaction as factors of 'built capital' and sub-factors of subjective (or personal) wellbeing as factors of 'social capital' and 'psychological capital'. This study found that several subfactors of wellbeing (e.g., community connectedness and achievement in life) may not be able to develop significant pathways. In addition, significant pain-related pathways contributed to mental distress via overall satisfaction with urban amenities and satisfaction with health facilities, and were associated with risk perception and health status. However, pathways related to satisfaction with social amenities (e.g., community facilities, indoor sports facilities) were associated with quality-of-life outcomes (e.g., standard of living and future security) rather than personal health status, possibly reflecting appreciation of the built environment and its perceived quality. The above results suggest that the sub-factors related to community capital play different roles in the biopsychosocial contexts of pain. These findings can be used to suggest multidimensional strategies to support pain patients living in the community. In particular, improving risk perception for injury prevention should be considered. © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.