Addressing Chronic Pain Disparities Between Black and White People: A Narrative Review of Socio-Ecological Determinants

Abstract

A 2019 review article modified the socio-ecological model to contextualize pain disparities among different ethnoracial groups; however, the broad scope of this 2019 review necessitates deeper socio-ecological inspection of pain within each ethnoracial group. In this narrative review, we expanded upon this 2019 article by adopting inclusion criteria that would capture a more nuanced spectrum of socio-ecological findings on chronic pain within the Black community. Our search yielded a large, rich body of literature composed of 174 articles that shed further socio-ecological light on how chronic pain within the Black community is influenced by implicit bias among providers, psychological and physical comorbidities, experiences of societal and institutional racism and biomedical distrust, and the interplay among these factors. Moving forward, research and public-policy development must carefully take into account these socio-ecological factors before scaling up pre-existing solutions with questionable benefit for the chronic pain needs of Black individuals.

Keywords::

• chronic pain
• disparities
• mechanisms
• psychosocial
• quality of care
• race and ethnicity

Author contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by TV Pham. The original draft of the manuscript was written by TV Pham, and all authors reviewed and edited previous versions of the manuscript. All authors read and approved the final manuscript.

Financial & competing interests disclosure

Dr Pham’s work was supported by K23AT012363. Dr Doorley’s work was supported by T32AT000051. Dr Kenney’s work was supported by K01HL169339. Dr Vranceanu’s work was supported by K24AT011760. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.