Chronic pain severity depends on race, neighborhood socioeconomic status
MedWire News: Race and neighborhood socioeconomic (SES) status contribute to disparity in chronic pain among young adults living in the USA, shows research.
The study, published in The Journal of Pain, demonstrated that poor neighborhood status was associated with worse chronic pain, and that Black race was also independently associated with pain-management difficulties.
"All Americans have not uniformly benefited from the technological advances that have increased longevity. Since racial and ethnic minorities often do not gain the same health advantages as whites with increasing SES, it is likely race and SES are interactive," explain Carmen Green and Tamera Hart-Johnson of the University of Michigan in Ann Arbor, USA. They therefore embarked on this research to distinguish between the effects of race and SES on chronic pain, as the two are often highly correlated.
The researchers analyzed data from 3730 young adults between 18 and 49 years old diagnosed with chronic pain at a tertiary care pain center between 1993 and 2000; 9.7% of the cohort were Black and 61% were female. The participants reported on their race and each patient's recorded address was compared with census data to provide neighborhood SES variables. The variables included: the percentage of households below the poverty line, the percentage of people 25 years or older with less than a high school education, and the percentage of people in the labor force who are employed.
Pain severity was recorded using the McGill Pain Questionnaire, which uses 20 sets of descriptive words to determine pain levels. The researchers also measured disability using the Pain Disability Index, and depression using the Beck Depression Inventory.
They found that both Black race and low neighborhood SES were independently associated with affective pain and "other" pain. Racial disparity in sensory pain and mood disorders were mediated by neighborhood SES, so that higher sensory pain in Black patients may be explained by residency in lower SES neighborhoods.
"Our results provide support for race as well as neighborhood [SES] influencing the pain experience but further suggests that better [SES] is not protective for young blacks in the same way it is for young whites," said Green in a press release.
She went on to conclude: "Our findings show an unequal burden of pain in blacks and among those living in poor neighborhoods among the 116 million adults who experience chronic pain. As the US increasingly diversifies, and the prevalence of pain increases, it is critically important to examine health disparities due to pain in vulnerable populations."
By Chloe McIvor