Prospective Study of Racial and Ethnic Disparities in Chronic Pain and Pain Burden

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 DESCRIPTION (provided by applicant): Chronic pain poses a disproportionate public health burden on racial and ethnic minorities. Substantial inequities exist in the pain treatment received by African-Americans and Latinos relative to their non-Latino White counterparts. Data suggest that members of these minority groups are not only more likely to develop chronic pain but also to have this pain accompanied by greater pain burden, i.e., greater suffering, poorer life quality, and worse functional impairment. Only modest headway has been made in understanding why race and ethnicity confer pain inequities and how best to address these disparities. The long-term objective of the proposed research is to contribute to the reduction or outright elimination o racial and ethnic pain disparities. The near-term goal of the planned research is to identify a small set of the most promising intervention targets, from among the plethora of posited explanations, for reducing or eliminating racial/ethnic pain disparities. The planned study would be, to our knowledge, the first ever prospective examination of factors posited to underlie racial and ethnic disparities in the transition from acute to chronic pain. The study would also be the first to investigate these issues in the important context of recovery following serious physical injury requiring hospitalization. For the proposed research, a sample of 900 adult survivors of serious physical injury, comprised of roughly equal proportions of African-Americans, Latinos, and non-Latino Whites, will be recruited during hospitalization from large trauma centers in Los Angeles, CA and Philadelphia, PA. Interviews will be conducted during hospitalization and at 3-, and 12-month follow-up. Medical records will provide information on injury severity and medication use in-hospital which may influence the course of pain. The specific aims are (1) to determine whether African-American and Latino physical injury survivors experience more severe pain following injury relative to their non-Latino White counterparts; (2) to determine whether African-American and Latino injury survivors experience greater pain burden relative to their non- Latino White counterparts; (3) to determine whether African-American and Latino differences in pain severity or pain burden can be linked to a small set of promising candidates to serve as targets for interventions aimed at reduction or elimination of pain outcome disparities; and (4) To determine whether pain outcomes in at-risk minority groups can be linked to a small set of promising candidates to serve as targets for group-tailored interventions to reduce pain severity and pain burden irrespective of whether these candidates contribute to between-group pain disparities. The knowledge gained from the proposed research has high potential to accelerate efforts aimed at eliminating racial and ethnic pain disparities by identifying promising targets for prevention and intervention efforts to close the pain gap.