Health Care Disparity in Pain

Hamilton, Travis; Reese, Jared C.; Air, Ellen L.

doi:10.1016/j.nec.2022.02.003

Cited by 2 publications

(3 citation statements)

References 51 publications

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“…One factor that prior reviews have highlighted as a contributor to racial disparities in pain outcomes involves group differences in pain assessment and treatment, which are widespread across settings. 22,30,36 For example, minority patients are consistently less likely to receive comprehensive diagnostic and treatment approaches for pain and more likely to have their pain underestimated by providers. 20,23,30 In previous studies of football players, injured Black professional ASF players (compared with their White peers) were deemed more likely to be able to play in a subsequent game with the assumption that they felt less pain than White players.…”

Section: Discussionmentioning

confidence: 99%

“…30,36 Recent reviews highlight the greater intensity of acute pain, the greater prevalence, severity, and impact of chronic pain, and the reduced access to and receipt of high-quality pain care among African Americans relative to White adults in the United States. 22,26,30 Race differences in health outcomes, including pain, are in part driven by social factors such as discrimination and bias, which have led to inequities in neighborhood environment, medical care, and socioeconomic position across the lifespan (ie, African Americans report more difficult socioeconomic circumstances relative to White Americans in the early life, midlife, and late life). 36 Professional American-style football (ASF) players represent a racially diverse group in which a majority of active professional players identify as Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.…”

Section: Introductionmentioning

confidence: 99%

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Race differences in pain and pain-related risk factors among former professional American-style football players

Edwards¹,

Tan

Dairi³

et al. 2023

PAIN

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The burden of pain is unequal across demographic groups, with broad and persisting race differences in pain-related outcomes in the United States. Members of racial and ethnic minorities frequently report more pervasive and severe pain compared with those in the majority, with at least some disparity attributable to differences in socioeconomic status. Whether race disparities in pain-related health outcomes exist among former professional football players is unknown. We examined the association of race with pain outcomes among 3995 former professional American-style football players who self-identified as either Black or White. Black players reported more intense pain and higher levels of pain interference relative to White players, even after controlling for age, football history, comorbidities, and psychosocial factors. Race moderated associations between several biopsychosocial factors and pain; higher body mass index was associated with more pain among White but not among Black players. Fatigue and psychosocial factors were more strongly related to pain among Black players relative to White players. Collectively, the substantial social and economic advantages of working as a professional athlete did not seem to erase race-related disparities in pain. We highlight an increased burden of pain among elite Black professional football players and identify race-specific patterns of association between pain and biopsychosocial pain risk factors. These findings illuminate potential future targets of interventions that may serve to reduce persistent disparities in the experience and impact of pain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Race differences in pain and pain-related risk factors among former professional American-style football players

Edwards¹,

Tan

Dairi³

et al. 2023

PAIN

View full text Add to dashboard Cite

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“…Other factors that may impact the treatment of patients with chronic pain include health disparities, such as access to care and insurance, socioeconomic barriers, and racial and ethnic disparities [ 37 ]. In the current study, there was a wide variability in the number of clinician notes per patient for the management of erythromelalgia and a number of patients that were lost to follow up in the clinic.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characterization of Pediatric Erythromelalgia: A Single-Center Case Series

Sun,

Ocay,

Halpin

et al. 2023

Children

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Erythromelalgia is a descriptive term for severe burning pain and erythema in the distal extremities relieved by cold and exacerbated by heat. Pediatric case series to date are relatively small. We extracted and analyzed medical record data for 42 pediatric patients to describe clinical characteristics, associated conditions, and responses to treatments. Informed consent was obtained according to an IRB-approved protocol that included gene discovery. Three patients had confirmed Nav1.7 sodium channelopathies, with six additional patients under investigation with novel gene candidates. There was a female predominance (2.5:1), and the median onset age was 12 years (IQR = 3–14). Patients saw a median of three specialists (IQR = 2–3) for a diagnosis. The majority (90%) reported bilateral symptoms. Cooling methods usually provided partial relief, while heat and exercise exacerbated pain. No medication appeared to be consistently effective; commonly prescribed medications included sodium channel blockers (n = 37), topical analgesics (n = 26), gabapentin (n = 22), and aspirin (n = 15). Based on the currently published literature, we believe this cohort is the largest pediatric study of erythromelalgia to date. Many findings are consistent with those of previously published case series. Work is in progress to establish a prospective cohort and multi-center registry.

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Health Care Disparity in Pain

Cited by 2 publications

References 51 publications

Race differences in pain and pain-related risk factors among former professional American-style football players

Race differences in pain and pain-related risk factors among former professional American-style football players

Clinical Characterization of Pediatric Erythromelalgia: A Single-Center Case Series

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