Relationship of pain and ancestry in African American women

Abstract

Background African Americans are reported to be more sensitive to pain than European Americans. Pain sensitivity has been shown to be genetically linked in animal models and is likely to be in humans. Methods 11,239 self-identified African American post menopausal women enrolled in the Women’s Health Initiative had percentage African ancestry determined by ancestry informative markers, “Pain Construct” measurements and covariate information. They answered 5 questions about specific types and location of pain, such as joint, neck, low back, headache, and urinary. They also answered 2 questions which were used to derive a “Pain Construct”, a measure of general pain scored on a scale of 1 to 100. Associations were tested in linear regression models adjusting for age, self-reported medical conditions, neighborhood socio-economic status, education, and depression. Results In the unadjusted model of the 5 specific types of pain measures, greater pain perception was associated with a higher proportion of African ancestry. However, some of the specific types of pain measures were no longer associated with African ancestry after adjustment for other study covariates. The Pain Construct was statistically significantly associated with African ancestry in both the unadjusted [Beta = −0.132, 95% confidence interval (C I) = −099 – −0.164; r = −0.075, 95% CI −0.056 – −0.093] and the adjusted models (Beta = −0.069 95% CI = −0.04 – 0.10). Conclusions Greater African ancestry was associated with higher levels of self-reported pain although this accounted for only a minor fraction of the overall variation in the Pain Construct.

Pain Interference, Psychopathology, and General Medical Conditions Among Black and White Adults in the US General Population

“…The strong associations across study groups between moderate or severe pain interference and a range of Axis-I disorders as well as general medical conditions emphasize the importance of the routine assessment of psychopathology in patients with pain interference and, conversely, pain interference in patients seeking treatment for psychiatric disorders. Our findings underscore those from prior studies indicating that further investigation of race-related differences in pain interference is warranted, including systematic examination of the extent to which these differences are mediated or moderated by socioeconomic status and other factors (e.g., stress, access to healthcare, genetics) (Portenoy et al, 2004, Meghani et al, 2012, Bekanich et al, 2014, Robbins et al, 2015). …”

Differences in Pain Coping Between Black and White Americans: A Meta-Analysis

“…Finally, race differences in coping may be primarily driven by differences in culture, for which race serves as a frequently measured but imprecise proxy. Indeed, Robbins and colleagues [71] suggest that genetically identified ancestral differences account for a small fraction of the variation in pain between White and Black individuals. Unfortunately, we could not address the issue of culture in the current meta-analysis due to lack of data.…”

Big data: Little difference

“…In this issue of the journal, John Robbins and his colleagues (Robbins et al., ) reported an analysis which tested for an association between the degree of African ancestry in American women and the report of pain. Robbins and his colleagues rightly note that in most previous research, ethnicity has been self‐defined.…”