Review

Racial and ethnic differences in the experience and treatment of noncancer pain

*Author for correspondence: Tel.: +1 617 732 9014;

Department of Anesthesiology, Pain Management Center, Brigham & Women’s Hospital, Harvard Medical School, Chestnut Hill, MA 02467, USA

Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA

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Alejandro Cortes

Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopaedic Surgery, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA

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Calia A Morais

Department of Psychology, The University of Alabama, Tuscaloosa, AL 35487, USA

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Robert R Edwards

Department of Anesthesiology, Pain Management Center, Brigham & Women’s Hospital, Harvard Medical School, Chestnut Hill, MA 02467, USA

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Published Online:29 May 2019https://doi.org/10.2217/pmt-2018-0030

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Abstract

The burden of pain is unequal across racial and ethnic groups. In addition to racial and ethnic differences in the experience of pain, there are racial and ethnic disparities in the assessment and treatment of pain. In this article, we provide a nonexhaustive review of the biopsychosocial mechanistic factors contributing to racial and ethnic differences in both the experience and treatment of pain. Using a modified version of the Socioecological Model, we focus on patient-, provider- and system-level factors including coping, perceived bias and discrimination, patient preferences, expectations, patient/provider communication, treatment outcomes and healthcare access. In conclusion, we provide psychosocial factors influencing racial and ethnic differences in pain and highlight future research targets and possible solutions to reduce these disparities.

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Vol. 9, No. 3

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History

Received 21 May 2018

Accepted 12 December 2018

Published online 29 May 2019

Published in print May 2019

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Keywords

Author contributions

SM Meints, A Cortes and CA Morais: conception and design of work, drafting manuscript, final approval and accountability for integrity of work. RR Edwards: conception and design of work, revision of manuscript for intellectual content, final approval, accountability for integrity of work.

Financial & competing interests disclosure

This work is supported by the NIH under award (grant number: T32 AR055885). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

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