• Overview
  • Ethnicity and Culture
  • Models of Pain Management
  • Evaluating Literature
  • Professional Training, Licensure & Credentials
• Interventions
  • Common Approaches
  • Theories of Mechanism
  • Safety and Adverse Effects
• Conditions
  • Selected Conditions
  • Text Resources
  • Web Resources

Ethnicity and Culture

Although disparities in morbidity and mortality by minority status in the U.S. have been documented for decades, only in recent years have significant resources been put towards understanding and eradicating them.  The Healthy People 2010 initiative has two main goals: (1) to increase the quality and years of healthy life, and (2) to eliminate health disparities (for more information see: http://www.healthypeople.gov/About/goals.htm). 

Disparities in health status based on socioeconomic class, insurance status or cultural background are increasingly recognized as factors that should be taken into account in healthcare delivery, clinical trials, and health services research. Research on differences in pain perception and tolerance and differences and disparities in pain treatment based on ethnicity or cultural background is growing.

Current research is going beyond documenting pain disparities and differences based on ethnicity or gender to explicating the factors that account for such differences.  Given different disciplines, research contexts, limited sample sizes, variation in the definition of “ethnicity” and culture, differences in pain measures and rather crude statistical analyses argue that culture has a vital influence on illness beliefs and behaviors, health care practices, help-seeking activities, and receptivity to western medical care interventions.   

When reviewing evidence regarding the safety and efficacy of allopathic or alternative interventions for pain, it is important to note the demographic background of the research participants.  Recent work with different ethnic groups on the experience and receptivity to the treatment of cancer pain suggest that the US healthcare system may be the system of last resort for many members of ethnic minority groups who will use their traditional medicines and healers before accessing US healthcare. 

Resources

• Publication of the International Association for the Study of Pain (IASP). Pain: Clinical Updates, Vol. X No. 5, Dec. 2002. This issue highlights distinctions between race, culture, and ethnicity, and reviews research on how these three factors interact to shape the experience of pain and its treatment. http://www.iasp-pain.org/PCU02-5.htm

• Ethnicity and Pain. Pain: Clinical Updates, Vol IX No. 4, Nov. 2001. This issue highlights the perplexities of ethnic differences in the prevalence and severity of clinical pain and in responses to clinical and experimental pain. Discusses ethnicity as a relatively understudied concept in pain medicine http://www.iasp-pain.org/PCU01-4.html