Racial and Ethnic Disparities in Pain Management in the United States

Ezenwa, Miriam O.; Ameringer, Suzanne; Ward, Sandra E.; Serlin, Ronald C.

doi:10.1111/j.1547-5069.2006.00107.x

Cited by 78 publications

(64 citation statements)

References 39 publications

(56 reference statements)

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“…With respect to race alone, AfricanAmericans experienced a difference in 2-year KSSs when compared with other races: African-Americans had a lower (p = 0.001) average 2-year KSS (86. 8 (Table 5). …”

Section: Resultsmentioning

confidence: 99%

“…Several studies suggest differences in function between races after joint arthroplasty [8,11,19,33]. Others have reported differences in the experience of pain by patients and in the management of that pain [8,33].…”

Section: Introductionmentioning

confidence: 99%

“…Others have reported differences in the experience of pain by patients and in the management of that pain [8,33]. Green et al [11] found chronic pain affects the quality of life and health status of the African-American population to a greater extent than in Caucasians in the United States.…”

Section: Introductionmentioning

confidence: 99%

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Ethnic and Gender Differences in the Functional Disparities after Primary Total Knee Arthroplasty

Kamath

Horneff

Gaffney

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background The benefits of TKA have been well documented. Whether these benefits apply equally across gender and ethnic groups is unclear. Given the underuse of TKA among certain demographic groups, it is important to understand whether gender or ethnicity influence pain and function after TKA. Questions/purposes We determined (1) the influence of race, gender, and body mass index (BMI) on primary TKA functional scores and ROM before gender-specific implants; and (2) months).Results African-Americans had longer delays to presentation, higher BMI, and worse 2-year KSS. Women (all races) had higher BMI and worse preoperative flexion/arc ROM. African-American women had worse final ROM and had similar final gains in ROM (postoperative minus preoperative ROM) after controlling for confounders. Conclusions Gender and race affected functional KSS and ROM variables. The worse results experienced by AfricanAmerican women may be attributable to a longer delay to presentation. However, the scores and motion were high for all subgroups, and underuse of TKA in women and AfricanAmericans cannot be justified based on a perception of lesser functional gains. Level of Evidence Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ethnic and Gender Differences in the Functional Disparities after Primary Total Knee Arthroplasty

Kamath

Horneff

Gaffney

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Several factors may influence these practices, including patients' attitudes, language barriers, heterogeneity of groups, and the medical costs involved [4]. A retrospective cohort study conducted in a hospital emergency department in Atlanta disclosed that only 57% of African American patients received adequate analgesia compared to 74% of White American patients (p = 0.01) [3].…”

Section: Introductionmentioning

confidence: 99%

“…One particular study showed that ethnicity indeed influenced patients' pain and analgesic prescriptions [4]. This post-operative pain study was conducted among women in Singapore who had undergone a lower uterine segment caesarean section procedure.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Culture on Analgesic Consumption: A Retrospective Study among Malaysian Patients after Breast Cancer Surgery

Japar¹,

Soh²,

Geok³

et al. 2015

JBM

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This study was carried out to determine the relationship between ethnicity/culture and analgesic consumption among patients from three main ethnic groups in Malaysia after breast cancer surgery. A retrospective study design was adopted, using medical records of 80 patients. The findings showed that the analgesic most consumed by the patients during the 48 hour post-operative period was morphine equivalents (85%), followed by non steroidal anti-inflammatory drugs (60%) and paracetamol (38%). No relationship was found between ethnicity/culture and the type or amount of analgesic consumption.

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Racial and ethnic differences in the use of lumbar imaging, opioid analgesics and spinal surgery for low back pain: A systematic review and meta‐analysis

Chen

Vella

Maher

et al. 2023

European Journal of Pain

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Background and Objective: There is a substantial gap between evidence and clinical care for low back pain (LBP) worldwide despite recommendations of best practice specified in clinical practice guidelines. The aim of this systematic review was to identify disparities associated with race or ethnicity in the use of lumbar imaging, opioid analgesics, and spinal surgery in people with LBP. Databases and Data Treatment:We included observational studies which compared the use of lumbar imaging, opioid analgesics, and spinal surgery for the management of non-serious LBP between people from different racial/ethnic populations. We searched in MEDLINE, EMBASE and CINAHL from January 2000 to June 2021. Risk of bias of included studies was appraised in six domains.For each type of care, we pooled data stratified by race and ethnicity using random effects models. Results:We identified 13 eligible studies; all conducted in the United States. Hispanic/Latino (OR 0.69, 95%CI 0.49-0.96) and Black/African American (OR 0.59, 95%CI 0.46-0.75) people with LBP were less likely to be prescribed opioid analgesics than White people. Black/African Americans were less likely to undergo or be recommended spinal surgery for LBP (OR 0.47, 95%CI 0.33-0.67) than White people. There was a lack of high certainty evidence on racial/ethnic disparities in the use of lumbar imaging. Conclusion:This review reveals lower rate of the use of guideline-discordant care, especially opioid prescription and spinal surgery, in racial/ethnic minority populations with LBP in the United States. Future studies in other countries evaluating care equity for LBP are warranted. PROSPERO Registration ID: CRD42021260668.Significance: This systematic review and meta-analysis revealed that people with low back pain from the minority racial/ethnic backgrounds were less likely to be prescribed opioid analgesics and undergo spinal surgery than the majority counterparts. Strategic interventions to improve the access to, and the value of, clinical care for minority populations with low back pain are warranted.

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Racial and Ethnic Disparities in Pain Management in the United States

Cited by 78 publications

References 39 publications

Ethnic and Gender Differences in the Functional Disparities after Primary Total Knee Arthroplasty

Ethnic and Gender Differences in the Functional Disparities after Primary Total Knee Arthroplasty

The Influence of Culture on Analgesic Consumption: A Retrospective Study among Malaysian Patients after Breast Cancer Surgery

Racial and ethnic differences in the use of lumbar imaging, opioid analgesics and spinal surgery for low back pain: A systematic review and meta‐analysis

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