Racial and Ethnic Disparities in Pain Management
Keywords:Public health, clinician-rated outcomes, patient-rated outcomes, professional standards
Pain is subjective, which makes its management a complicated task. The challenge of medical decision-making associated with pain often requires health care providers to rely heavily on their individual discretion and experience. This often creates an avenue for biases to play a role in the selection of the best available and most appropriate pain management interventions. Therefore, the overall purpose of this review is to summarize the current literature related to racial and ethnic disparities in pain management. Electronic searches of four databases revealed 2,112 articles; however, only six studies met criteria for inclusion in this review. Even when the source of pain is the same, research indicates management may differ between racial or ethnic groups. While the treatment of objectively painful conditions remains relatively constant among races and ethnicities, inequities in pain management become more apparent in the treatment of conditions characterized by only subjective pain indicators. Further disparities were identified in the dosage, dosage reduction, and oversight of opioid analgesics between groups. Inequities in prescribing patterns widen existing healthcare disparities by contributing to undertreatment of pain in ethnic minorities and overtreatment of pain and subsequent risk of opioid abuse in Whites. Health care providers must use a patient-centered and evidence-based approach to combat the ambiguity of clinical decision-making regarding pain. When knowledgeable of appropriate standard of care for pain management, athletic trainers can identify when a patient’s pain needs are unmet or when substance abuse interventions may be necessary.