The unequal burden of pain: Confronting racial and ethnic disparities in pain

被引:880
作者
Green, CR
Anderson, KO
Baker, TA
Campbell, LC
Decker, S
Fillingim, RB
Kaloukalani, DA
Lasch, KE
Myers, C
Tait, RC
Todd, KH
Vallerand, AH
机构
[1] Univ Michigan, Sch Med, Dept Anesthesiol, Ann Arbor, MI 48109 USA
[2] Univ Texas, MD Anderson Canc Ctr, Pain Res Grp, Houston, TX 77030 USA
[3] Univ Michigan, Sch Publ Hlth, Ann Arbor, MI 48109 USA
[4] Duke Univ, Med Ctr, Durham, NC USA
[5] Univ Iowa, Sch Nursing, Iowa City, IA USA
[6] Univ Florida, Coll Dent, Gainesville, FL USA
[7] Washington Univ, St Louis, MO USA
[8] Tufts Univ New England Med Ctr, Boston, MA 02111 USA
[9] Univ Calif Los Angeles, Los Angeles, CA USA
[10] St Louis Univ, Sch Med, St Louis, MO USA
[11] Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA
[12] Wayne State Univ, Coll Nursing, Detroit, MI 48202 USA
关键词
racial and ethnic disparities; pain; pain perception; pain assessment and treatment; health care provider; health care system;
D O I
10.1046/j.1526-4637.2003.03034.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Context. Pain has significant socioeconomic, health, and quality-of-life implications. Racial- and ethnic-based differences in the pain care experience have been described. Racial and ethnic minorities tend to be undertreated for pain when compared with non-Hispanic Whites. Objectives. To provide health care providers, researchers, health care policy analysts, government officials, patients, and the general public with pertinent evidence regarding differences in pain perception, assessment, and treatment for racial and ethnic minorities. Evidence is provided for racial- and ethnic-based differences in pain care across different types of pain (i.e., experimental pain, acute postoperative pain, cancer pain, chronic non-malignant pain) and settings (i.e., emergency department). Pertinent literature on patient, health care provider, and health care system factors that contribute to racial and ethnic disparities in pain treatment are provided. Evidence. A selective literature review was performed by experts in pain. The experts developed abstracts with relevant citations on racial and ethnic disparities within their specific areas of expertise. Scientific evidence was given precedence over anecdotal experience. The abstracts were compiled for this manuscript. The draft manuscript was made available to the experts for comment and review prior to submission for publication. Conclusions. Consistent with the Institute of Medicine's report on health care disparities, racial and ethnic disparities in pain perception, assessment, and treatment were found in all settings (i.e., postoperative, emergency room) and across all types of pain (i.e., acute, cancer, chronic nonmalignant, and experimental). The literature suggests that the sources of pain disparities among racial and ethnic minorities are complex, involving patient (e.g., patient/health care provider communication, attitudes), health care provider (e.g., decision making), and health care system ( e. g., access to pain medication) factors. There is a need for improved training for health care providers and educational interventions for patients. A comprehensive pain research agenda is necessary to address pain disparities among racial and ethnic minorities.
引用
收藏
页码:277 / 294
页数:18
相关论文
共 185 条
  • [1] *ADM AG, 1994 1995 NAT HLTH I
  • [2] *AG HLTH CAR POL R, 1992, AC PAIN MAN OP MED P
  • [3] Population aging: A comparison among industrialized countries
    Anderson, GF
    Hussey, PS
    [J]. HEALTH AFFAIRS, 2000, 19 (03) : 191 - 203
  • [4] ANDERSON K, 2003, PAIN S1, V4, P95
  • [5] Anderson KC, 2000, CANCER, V88, P1929, DOI 10.1002/(SICI)1097-0142(20000415)88:8<1929::AID-CNCR23>3.0.CO
  • [6] 2-2
  • [7] Cancer pain management among underserved minority outpatients - Perceived needs and barriers to optimal control
    Anderson, KO
    Richman, SP
    Hurley, J
    Palos, G
    Valero, V
    Mendoza, TR
    Gning, I
    Cleeland, CS
    [J]. CANCER, 2002, 94 (08) : 2295 - 2304
  • [8] [Anonymous], 1998, J Am Geriatr Soc, V46, P635
  • [9] [Anonymous], 1988, CLIN CHEM
  • [10] [Anonymous], CULTURAL CLIN PSYCHO