Background & Aims
Chronic pain represents a major burden on individuals and health care systems globally. Worldwide, more than 30% of individuals suffer from chronic pain [1]. Beyond physical symptoms, patients with chronic pain struggle with emotional, social, and financial difficulties stemming from their pain. As the Covid-19 pandemic highlighted, chronic diseases have a disproportionately large impact on marginalized communities, especially racial and ethnic minorities [2,3]. Studies have demonstrated that among US chronic pain patients, Black patients are more likely than White patients to experience severe pain and increased pain interference [4,5]. The weathering hypothesis suggests that these discrepancies may be the result of long-term exposure to discrimination, socioeconomic disadvantages and systemic inequities [6]. In this study we aimed to investigate the complex relationships between pain diagnoses, race and ethnicity, and socioeconomic status.
Methods
In our analyses we used sociodemographic data, lifestyle data, and hospital records from over 250,000 women who participated in the UK Biobank. Odds ratios for pain conditions were calculated between Black and White women based on age-adjusted prevalence of ICD-10 diagnoses from hospital records. Bonferroni corrections were applied to account for multiple comparisons.
Results
Our preliminary results found significant disparities in the prevalence of certain conditions between Black and White women. Back pain was notably more prevalent in Black women, with an odds ratio (OR) of 2.0 and a highly significant p-value (<0.001). Joint pain was found to be more common in Black women compared to White women, as indicated by an OR of 1.6 and a p-value <0.001. Additionally, endometriosis showed a higher incidence in Black women, with an OR of 1.8 and a p-value of <0.005.
Conclusions
The findings of markedly higher odds ratios for back pain, joint pain, and endometriosis in black women underscore the critical need for targeted healthcare strategies to address these inequities. Forthcoming analyses looking at the roles of social and material deprivation will help elucidate how race and socioeconomic status interact to influence pain. This study not only highlights the disproportionate burden of chronic pain on racial and ethnic minorities but also emphasizes the importance of considering social determinants of health in patient care. By addressing these disparities, healthcare systems can move towards more equitable healthcare provision, ultimately reducing the broad spectrum of consequences associated with chronic pain.
References
[1] Cohen, S. P., Vase, L., & Hooten, W. M. (2021). Chronic pain: an update on burden, best practices, and new advances. Lancet, 397(10289), 2082-2097. https://doi.org/10.1016/S0140-6736(21)00393-7
[2] Lo, C. H., Nguyen, L. H., Drew, D. A., Warner, E. T., Joshi, A. D., Graham, M. S., Anyane-Yeboa, A., Shebl, F. M., Astley, C. M., Figueiredo, J. C., Guo, C. G., Ma, W. J., Mehta, R. S., Kwon, S., Song, M. Y., Davies, R., Capdevila, J., Sudre, C. H., Wolf, J., . . . Consortium, C. (2021). Race, ethnicity, community-level socioeconomic factors, and risk of COVID-19 in the United States and the United Kingdom. Eclinicalmedicine, 38. https://doi.org/ARTN 10102910.1016/j.eclinm.2021.101029
[3] Green, C. R., Anderson, K. O., Baker, T. A., Campbell, L. C., Decker, S., Fillingim, R. B., Kaloukalani, D. A., Lasch, K. E., Myers, C., Tait, R. C., Todd, K. H., & Vallerand, A. H. (2003). The unequal burden of pain: Confronting racial and ethnic disparities in pain. Pain Medicine, 4(3), 277-294. https://doi.org/DOI 10.1046/j.1526-4637.2003.03034.x
[4] Mullins, P. M., Yong, R. J., & Bhattacharyya, N. (2022). Impact of demographic factors on chronic pain among adults in the United States. Pain Reports, 7(4). https://doi.org/ARTN e100910.1097/PR9.0000000000001009
[5] 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. J Gerontol A Biol Sci Med Sci, 77(2), e74-e81. https://doi.org/10.1093/gerona/glab207
[6] Forde, A. T., Crookes, D. M., Suglia, S. F., & Demmer, R. T. (2019). The weathering hypothesis as an explanation for racial disparities in health: a systematic review. Ann Epidemiol, 33, 1-18 e13. https://doi.org/10.1016/j.annepidem.2019.02.011
Presenting Author
Jax Norman
Poster Authors
Topics
- Racial/Ethnic/Economic Differences/Disparities