Mechanisms of injustice: what we (do not) know about racialized disparities in pain.
Mechanisms of injustice: what we (do not) know about racialized disparities in pain.
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DOI：
10.1097/j.pain.0000000000002528
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发表时间：
2022-06-01
期刊：
影响因子：
7.4
通讯作者：
中科院分区：
文献类型：
--
作者：
大约20年前，疼痛差异研究的领导者向疼痛科学家和临床医生发出挑战，要求他们介入并倡导消除基于种族主义身份的不公平疼痛治疗39(表1)。然而，尽管做出了重大努力，导致将疼痛差异纳入国家优先事项，但34，40名研究人员继续确定更严重的疼痛程度，更差的疼痛结果，以及对小规模群体的不同治疗。24、65、70痛苦经历方面种族主义差异的持续性质突出表明，需要采取关键行动来解决这一基于平等的僵局，特别是在当前社会政治上迫切需要为种族主义群体伸张正义和进行社会变革的情况下。7作为这一努力的一部分，本审查认为，在一个更大的互动系统框架内，从不公正的角度对疼痛差异进行概念化是最恰当的。到目前为止，研究的重点是个人的不公正经历。然而，忽视维持和延续不公正的制度，限制了我们对差距机制的理解，并放慢了干预的道路。在这篇文章中，我们(1)提供了不公正镜头的理论基础，(2)描述了一个模型，通过该模型，不公正程度创造和维持了疼痛差异，(3)在这个框架内将种族主义疼痛差异的当前知识联系起来，以及(4)讨论了这种典型性变化如何将干预的重点转向消除疼痛差异。必须指出的是，不公正的经历对大多数慢性疼痛患者来说是常见的和重要的15、28、96；这些经历对于那些面临多系统和跨部门不公正的人来说更加严重，96、105这里提出的概念应该适用于根据其身份的任何方面划分的人口，并对其进行审查。然而，为了集中那些受不公正和不同痛苦结果影响最大的人的经历，77这篇综述将突出美国黑人种族主义的不公正经历，以说明多系统不公正如何不成比例地在人群中形成痛苦负担。
Almost 20 years ago, leaders in pain disparities research challenged pain scientists and clinicians to intervene and advocate for the elimination of inequitable pain treatment based on racialized identity39 (Table 1). However, despite significant efforts that led to the inclusion of pain disparities in national priorities, 34, 40 researchers continue to identify greater pain severity, worse pain outcomes, and disparate treatment for minoritized groups. 24, 65, 70 The persistent nature of racialized disparities in pain experience underscores the need for critical action to address this equitybased impasse, particularly amidst the current sociopolitical urgency toward justice and social change for racialized groups. 7 As part of this effort, the present review contends that pain disparities are most appropriately conceptualized from an injustice perspective within a larger interacting systems framework. To date, research has focused on the injustice experiences of individuals. However, overlooking the systems that maintain and perpetuate injustice has limited our understanding of disparity mechanisms and slowed paths toward intervention. In this article, we (1) provide a rationale for an injustice lens,(2) describe a model by which levels of injustice create and maintain pain disparities,(3) contextualize current knowledge of racialized pain disparities within this framework, and (4) discuss how this paradigmatic change shifts intervention priorities toward eliminating pain disparities. It is important to note that experiences with injustice are common and significant for most people with chronic pain15, 28, 96; these experiences are exacerbated for those exposed to multisystemic and intersectional injustice, 96,105 and the concepts proposed here should apply and be examined with respect to populations minoritized based on any aspect of their identity. However, to center the experiences of those most affected by injustice and disparate pain outcomes, 77 this review will highlight the racialized injustice experience of Black Americans to illustrate how multisystemic injustice disproportionately patterns pain burden across populations.
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DOI：
10.1016/j.bbi.2020.07.017
发表时间：
2020-10
期刊：
Brain, behavior, and immunity
影响因子：
--
作者：
Cuevas AG;Ong AD;Carvalho K;Ho T;Chan SWC;Allen JD;Chen R;Rodgers J;Biba U;Williams DR
通讯作者：
Williams DR
影响因子：
3.1
作者：
Edwards, Robert R.
通讯作者：
Edwards, Robert R.
影响因子：
7.4
作者：
Dugan SA;Lewis TT;Everson-Rose SA;Jacobs EA;Harlow SD;Janssen I
通讯作者：
Janssen I
影响因子：
3.4
作者：
Coulon SJ;Velasco-Gonzalez C;Scribner R;Park CL;Gomez R;Vargas A;Stender S;Zabaleta J;Clesi P;Chalew SA;Hempe JM
通讯作者：
Hempe JM
影响因子：
16.4
作者：
BRONFENBRENNER, U
通讯作者：
BRONFENBRENNER, U