Background & Aims
Racialized disparities in pain experiences and inequities in pain care are well-documented. Evidence indicates that Black individuals often receive less adequate pain treatments, despite reporting more intense pain and having lower pain tolerance levels compared to their White counterparts. Structural, institutional, interpersonal, and intrapersonal factors are argued to be important explanatory mechanisms of these disparities and inequities. However, research into these mechanisms among children is limited. This study aims to address this gap by examining: 1) disparities in pain experiences (i.e., pain intensity, frequency, and tolerance) between Black/Brown and White youth; 2) their perceptions of racialized discrimination in pain care; and 3) whether racialized disparities in pain experiences are influenced by experiences of racialized discrimination in pain care.
Methods
Data were collected from 84 individuals aged 8-17 (Mage =15.17 years, SDage = 2.48). Among them, 64.6% identified as White and 35.4% as Black/Brown. Regarding gender, 75% identified as girls, 22.37% as boys, and 2.63% as gender-nonconforming. Participants were eligible for inclusion if they did not have chronic pain, a chronic illness (e.g., diabetes, asthma), or a developmental disorder (e.g., autism). Participants provided data on their pain intensity at the time of testing, and for the past two weeks and six months. They also reported the frequency of their pain over the past six months. Pain tolerance was assessed using the Cold Pressor Task, an experimental pain induction method. Additionally, participants’ experiences of racial discrimination in pain care were measured with a modified version of the Discrimination in Medical Settings scale. Statistical analyses, including ANOVA and Path Analysis, were conducted to explore potential racialized disparities and mediation.
Results
The results revealed consistent differences in pain experiences between Black/Brown and White youth. Black/Brown youth reported higher pain intensities during the past two weeks and six months compared to their White peers. Conversely, White youth reported more frequent pain over the past six months. Additionally, Black/Brown youth demonstrated lower pain tolerance than White youth. Perceptions of racialized discrimination in pain care were higher among Black/Brown relative to White youth. However, these perceptions did not mediate the relationship between participants’ self-identified race and any of the indicators of pain experience.
Conclusions
This is the first study to examine pain experiences and perceptions of racialized discrimination in pain care in a sample of Black/Brown and White youth in Belgium. The findings reveal racialized disparities in pain experiences and perceptions of racialized discrimination among children and adolescents. These perceptions, however, did not explain the observed differences in pain experiences. Overall, these findings suggest that racialized disparities in pain experience and perceptions of racialized discrimination in pain care manifest early in life, emphasizing the need for more inclusive and equitable pediatric pain care.
References
Anderson, K. O., Green, C. R., & Payne, R. (2009). Racial and Ethnic Disparities in Pain: Causes and Consequences of Unequal Care. Journal of Pain, 10(12), 1187–1204. https://doi.org/10.1016/j.jpain.2009.10.002
Baron, R., & Kenny, D. A. (1986). Acute oromandibular dystonia reaction related to a single low dose sertraline. Journal of Personality and Social Psychology, 51(6), 1173–1182. https://doi.org/10.1037/0022-3514.51.6.1173
Burgess, D. J., Grill, J., Noorbaloochi, S., Griffin, J. M., Ricards, J., Ryn, M. Van, & Partin, M. R. (2009). The Effect of Perceived Racial Discrimination on Bodily Pain. 10(8). https://doi.org/10.1111/j.1526-4637.2009.00742.x
Craig, K. D. (2015). Social communication model of pain. 156, 1198–1199.
Goodin, B. R., Glover, T. L., Sotolongo, A., King, C. D., Sibille, K. T., Herbert, M. S., Sanden, S. H., Staud, R., Redden, D. T., Bradley, L. A., & Fillingim, R. B. (2013). Perceived Racial Discrimination, but Not Mistrust of Medical Researchers, Predicts the Heat Pain Tolerance of African Americans With Symptomatic Knee Osteoarthritis. 32(11), 1117–1126.
Kim, H. J., Yang, G. S., Greenspan, J. D., Downton, K. D., Griffith, K. A., Renn, C. L., Johantgen, M., & Dorsey, S. G. (2017). Racial and ethnic differences in experimental pain sensitivity: Systematic review and meta-analysis. Pain, 158(2), 194–211. https://doi.org/10.1097/j.pain.0000000000000731
Losin, E. A. R., Woo, C. W., Medina, N. A., Andrews-Hanna, J. R., Eisenbarth, H., & Wager, T. D. (2020). Neural and sociocultural mediators of ethnic differences in pain. Nature Human Behaviour, 4(5), 517–530. https://doi.org/10.1038/s41562-020-0819-8
Meints, S. M., Cortes, A., Morais, C. A., & Edwards, R. R. (2019). Racial and ethnic differences in the experience and treatment of noncancer pain. Pain Management, 9(3), 317–334. https://doi.org/10.2217/pmt-2018-0030
Mendoza-Denton, R., Park, S. H., & O’Connor, A. (2008). Gender stereotypes as situation-behavior profiles. Journal of Experimental Social Psychology, 44(4), 971–982. https://doi.org/10.1016/j.jesp.2008.02.010
Peek, M. E., Nunez-Smith, M., Drum, M., & Lewis, T. (2011). Adapting the Everyday Discrimination Scale to Medical Settings. Ethnicity & Disease, 21(4), 502–509.
Rahim-williams, B., & Fillingim, R. B. (2012). NEUROSCIENCE SECTION Review Article A Quantitative Review of Ethnic Group Differences in Experimental Pain Response?: Do Biology, Psychology, and Culture Matter?? 522–540.
Reyes-Gibby, C. C., Aday, L. A., Todd, K. H., Cleeland, C. S., & Anderson, K. O. (2007). Pain in Aging Community-Dwelling Adults in the United States: Non-Hispanic Whites, Non-Hispanic Blacks, and Hispanics. Journal of Pain, 8(1), 75–84. https://doi.org/10.1016/j.jpain.2006.06.002
Williams, D. R., & Mohammed, Æ. S. A. (2009). Discrimination and racial disparities in health?: evidence and needed research. 20–47. https://doi.org/10.1007/s10865-008-9185-0
Yang, Y., Reid, M. C., Grol-Prokopczyk, H., & Pillemer, K. (2022). Racial-ethnic Disparities in Pain Intensity and Interference Among Middle-aged and Older U.S. Adults. Journals of Gerontology – Series A Biological Sciences and Medical Sciences, 77(2), E74–E81. https://doi.org/10.1093/gerona/glab207
Presenting Author
Ama Kissi
Poster Authors
Topics
- Racial/Ethnic/Economic Differences/Disparities