Factors associated with sexual orientation and gender disparities in chronic pain among U.S. adolescents and young adults

Katz-Wise, Sabra L.; Everett, Bethany G.; Scherer, Emily A.; Gooding, Holly C.; Milliren, Carly E.; Austin, S. Bryn

doi:10.1016/j.pmedr.2015.09.011

Cited by 20 publications

(10 citation statements)

References 35 publications

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“…The purpose of this study was to provide first person accounts of the relationship between experiences of pain and discrimination and stigma, thereby informing equity-oriented responses to chronic pain tailored to people experiencing both pain and social marginalization. To study the relationship between chronic pain and diverse experiences of social marginalization as well as implications for interventions, we conducted a community-based qualitative study using focus groups with people living with chronic pain and identifying with one of three groups known to experience high levels of inequity, discrimination, and stigma in Canada, specifically Indigenous 1 [ 34 , 35 ], LGBTQ2S 2 [ 36 ] and refugees or newcomers [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

Towards health equity for people experiencing chronic pain and social marginalization

Wallace

Varcoe

Holmes

et al. 2021

Int J Equity Health

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Objective For people who experience social inequities and structural violence, pain and related care are inexorably linked to experiences of injustice and stigma. The purpose of this study was to examine in greater depth the experiences of pain and discrimination and stigma across diverse marginalized communities in order to recommend equity-oriented healthcare approaches. Methods This community-based qualitative study reports on four focus groups that included 36 people living with pain. All participants identified with one of three groups known to experience high levels of inequities and structural violence including an Indigenous group, a LGBTQ2S group, and two newcomer and refugee groups. Results Pain was entangled with and shaped by: social locations and identities, experiences of violence, trauma and related mental health issues, experiences of discrimination, stigma and dismissal, experiences of inadequate and ineffective health care, and the impacts of these intersecting experiences. Conclusions Equity-oriented responses to chronic pain would recognize pain not only as a biomedical issue but as a social justice issue. The EQUIP Framework is an approach to integrating trauma- and violence-informed care; culturally-safe care; and harm reduction in health care that may hold promise for being tailored to people experiencing pain and social marginalization.

show abstract

Section: Introductionmentioning

confidence: 99%

Towards health equity for people experiencing chronic pain and social marginalization

Wallace

Varcoe

Holmes

et al. 2021

Int J Equity Health

View full text Add to dashboard Cite

show abstract

“…The purpose of this study was to provide rst person accounts of the relationship between experiences of pain and discrimination and stigma, thereby informing equity-oriented responses to chronic pain tailored to people experiencing both pain and social marginalization. To study the relationship between chronic pain and diverse experiences of social marginalization as well as implications for interventions, we conducted a community-based qualitative study using focus groups with people living with chronic pain and identifying with one of three groups known to experience high levels of inequity, discrimination, and stigma in Canada, speci cally Indigenous [1] (34,35), LGBTQ2S [2] (36) and refugees or newcomers (34) We employ a health equity framework to investigate the links among the complexities of inequities, social marginalization, and structural violence to inform equity-oriented responses to chronic pain. Namely, the EQUIP Health Care program of research (37)(38)(39)(40) informs the theoretical framework for this inquiry as well as the analytical processes.…”

Section: Introductionmentioning

confidence: 99%

Towards health equity for people experiencing chronic pain and social marginalization

Wallace

Varcoe

Holmes

et al. 2021

Preprint

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Objective: For people who experience social inequities and structural violence, pain and related care are inexorably linked to experiences of injustice and stigma. The purpose of this study was to examine in greater depth the experiences of pain and discrimination and stigma across diverse marginalized communities in order to recommend equity-oriented healthcare approaches. Methods: This community-based qualitative study reports on four focus groups that included 36 people living with pain. All participants identified with one of three groups known to experience high levels of inequities and structural violence including an Indigenous group, a LGBTQ2S group, and two newcomer and refugee groups. Results: Pain was entangled with and shaped by: social locations and identities, experiences of violence, trauma and related mental health issues, experiences of discrimination, stigma and dismissal, experiences of inadequate and ineffective health care, and the impacts of these intersecting experiences. Conclusions: Equity-oriented responses to chronic pain would recognize pain not only as a biomedical issue but as a social justice issue. The EQUIP Framework is an approach to integrating trauma- and violence-informed care; culturally-safe care; and harm reduction in health care that may hold promise for being tailored to people experiencing pain and social marginalization.

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“…1 These disparities emerge in adolescence and young adulthood, 2,3 including in mental health, 4,5 substance use behaviors, [6][7][8] HIV and other sexually transmitted infections (STIs), 9 unintended teen pregnancy, 10,11 cancer-related risk behaviors, 7,12 preventive health behaviors, 13 cardiovascular risk biomarkers, 14 eating disorder behaviors, [15][16][17] and chronic pain. 18 Whether being a sexual minority is measured by sexual identity (self-identification as lesbian, gay, or bisexual), sexual attraction (attraction to people of the same and/or different gender), sexual behavior (same and/or different gender sexual contact), or some combination of all 3 dimensions, health disparities are ubiquitous for LGB youth. 19 Health care utilization patterns, such as avoidance of or delay in seeking care, reduced access to health care, and difficulties communicating with clinicians, contribute to inequitable US health care outcomes.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Reported Health Care Use by Sexual Orientation Among Youth

et al. 2021

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IMPORTANCEIn the United States, adolescents who are lesbian, gay, or bisexual (LGB) face disparities across physical and mental health outcomes compared with non-LGB youth, yet few studies have looked at patterns of health care utilization by sexual orientation. OBJECTIVE To compare health care utilization indicators for LGB and non-LGB youth. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed wave 3 data from Healthy Passages, a longitudinal observational study of diverse public school students in Birmingham, Alabama; Houston, Texas; and Los Angeles County, California. Multivariable logistic regression models tested sexual-orientation differences in the past 12-month health care utilization measures, controlling for youth age, gender, race and ethnicity, household education, income, and marital status. Data collection began in 2010 when students were in the 5th grade (mean [SE] age, 11.13 [0.01] years) (wave 1) and continued 2 years later (wave 2, 7th grade) and 5 years later (wave 3, 10th grade). Permission to be contacted was provided for 6663 children, and 5147 (77%) participated in audio computer-assisted self-administered interviews. This study included 4256 youth (640 LGB, 3616 non-LGB) who completed interviews at wave 1 and wave 3 and answered key items used in this analysis. Analyses were completed in June 2021. EXPOSURES Sexual orientation (LGB vs non-LGB).MAIN OUTCOMES AND MEASURES Health care utilization and communication difficulty with a physician in the past 12 months. RESULTS Among 4256 youths included in the study at baseline in 5th grade (wave 1), 2171 (48.9%) were female; 1502 (44.5%) were Hispanic or Latino; 1479 (28.9%) were Black; the mean (SE) age was 11.19 (0.03) years; and 640 (14.5%) were LGB at wave 3. Compared with non-LGB youth, a higher proportion of LGB youth reported not receiving needed medical care in the last 12 months (adjusted odds ratio [aOR], 1.68; 95% CI,1.38-2.05), most commonly for sexually transmitted infections, contraception, and substance use. LGB youth more frequently reported difficulty communicating with their physician (aOR, 1.71; 95% CI, 1.27-2.30) than non-LGB youth.CONCLUSIONS AND RELEVANCE This study's results found that health care utilization differs by sexual orientation for youth. These findings suggest that clinician training is needed to address the health care needs of LGB youth. Routinely capturing sexual orientation data might enable tracking of health care utilization indicators for LGB youth.

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Factors associated with sexual orientation and gender disparities in chronic pain among U.S. adolescents and young adults

Cited by 20 publications

References 35 publications

Towards health equity for people experiencing chronic pain and social marginalization

Towards health equity for people experiencing chronic pain and social marginalization

Towards health equity for people experiencing chronic pain and social marginalization

Analysis of Reported Health Care Use by Sexual Orientation Among Youth

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