“Even my sister says I'm acting like a crazy to get a check”: Race, gender, and moral boundary-work in women's claims of disabling chronic pain

Pryma, Jane

doi:10.1016/j.socscimed.2017.03.048

Cited by 84 publications

(86 citation statements)

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“…Fibromyalgia syndrome (FMS) is a musculoskeletal disorder that is characterized by persistent and widespread pain. [1][2][3][4][5] It is most commonly diagnosed among middle-aged White women. 3,4 There are no agreed upon biomarkers or known etiology.…”

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confidence: 99%

“…[1][2][3][4][5] It is most commonly diagnosed among middle-aged White women. 3,4 There are no agreed upon biomarkers or known etiology. 5,6 However, researchers have suggested that genetics, abnormal nervous system functioning, socioeconomic status, along with other environmental triggers may be involved in the development of the condition.…”

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confidence: 99%

“…2 Others have suggested that the lower rates of diagnoses can be attributed to health care professionals distrusting racial/ethnic minority patients' claims of pain. 3 The diagnosis of FMS is exclusionary, often requiring that other possible causes for patients' symptoms be ruled out prior to a diagnosis being made. 3 For this reason, factors that limit or affect health seeking behaviors such as education level, socioeconomic status, and racial/ethnic minority status may play a role in whether the condition is recognized and correctly diagnosed by a healthcare provider.…”

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confidence: 99%

“…3 The diagnosis of FMS is exclusionary, often requiring that other possible causes for patients' symptoms be ruled out prior to a diagnosis being made. 3 For this reason, factors that limit or affect health seeking behaviors such as education level, socioeconomic status, and racial/ethnic minority status may play a role in whether the condition is recognized and correctly diagnosed by a healthcare provider. 8,9 Because racial/ethnic minorities are less likely to participate in research studies, 10 few researchers have examined how the symptoms of FMS vary as a function of racial/ethnic minority status.…”

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confidence: 99%

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<p>The Effects of Racial/Ethnic Minority Status on Sleep, Mood Disturbance, and Depression in People with Fibromyalgia</p>

Marr¹,

Liew²,

Carovich³

et al. 2020

PRBM

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Purpose: Fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain disorder that is characterized by persistent and widespread pain. FMS has been associated with sleep disturbance, mood disorders and depression. Racial/ethnic minorities are less likely to receive a diagnosis of FMS than White individuals. Although mood disorders and depression are prevalent among racial/ethnic minority groups, researchers have not examined whether there are differences between racial/ethnic minorities and White individuals with FMS. Participants and Methods: The participants were 600 people who were 18 years of age or older and who had a physician's diagnosis of FMS, which was confirmed using the 1990 American College of Rheumatology criteria. Most participants were female (95.5%) and White (85.0%). Sleep disturbance was assessed using the Pittsburgh Sleep Quality Index (PSQI), mood disturbance was assessed using the Profile of Mood States (POMS), and depression was assessed via the Center for Epidemiological Studies Depression Scale (CES-D). Results: Racial/ethnic minorities reported significantly greater levels of sleep disturbance, significantly greater levels of mood disturbance, and had significantly greater levels of depression than White participants. However, racial/ethnic minorities had significantly greater reductions in mood disturbance over the one-year period than White participants. Conclusion: Overall, the findings from the present study indicated that racial/ethnic minorities had "worse" physical and psychological outcomes than White participants.

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confidence: 99%

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confidence: 99%

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confidence: 99%

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<p>The Effects of Racial/Ethnic Minority Status on Sleep, Mood Disturbance, and Depression in People with Fibromyalgia</p>

Marr¹,

Liew²,

Carovich³

et al. 2020

PRBM

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“…Admitting or expressing pain that requires a break from work becomes antithetical to the Protestant work ethic (Weber ). Such stigma is heightened for those with less visible illnesses, such as chronic pain syndromes (Good et al ; Pryma , 7).…”

Section: Patient‐physician Relationship In Workers' Compensationmentioning

confidence: 99%

What the Doctors Don't See: Physicians as Gatekeepers, Injured Latino Immigrants, and Workers' Compensation System

Castillo

2018

Anthropology of Work Review

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Workers' compensation systems require injured employees to overcome cumbersome requirements in order to obtain health‐care and salary‐replacement benefits. The structural vulnerabilities of Latino immigrants put them at greater risk for workplace injuries and further complicate their search for redress. As a medico‐legal system, workers' compensation relies on medical professionals to interrogate the bodies of injured low‐wage immigrant workers. This article aims to clarify how workers' trajectories are impacted by interactions with health‐care system. Utilizing activist research methods, I collaborated with Fuerza Laboral, a worker center in Rhode Island, from the fall of 2013 to the end of 2014, to survey and interview injured Latino workers, physicians, and legal professionals. I bring together worker narratives and physician reflections to identify how the compensation system's reliance on biomedicine contributes to poor outcomes for injured immigrant workers. Considering the medical “gaze,” prejudice against injured workers, racial and ethnic bias in medicine, and the pitfalls of cultural competency training, I outline the mechanics of how the medical‐legal system corrodes the patient‐physician relationship. Evaluating the risks of positioning physicians as gatekeepers, I advocate for uncoupling medical evaluations from compensation cases, the importance of healthcare system reform, and medical curricula that emphasize structural analysis. Such reforms may liberalize access to health care for injured workers as well as stymie bias in medical education.

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Questioning Biomedicine's Privileging of Disease and Measurability

Kroll

2021

AMA Journal of Ethics

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Within biomedicine, the diagnosis of disease is often privileged over a patient's experience of illness. Yet up to 30% of primary care visits might be attributable to persistent illness without a diagnosed disease, including functional somatic syndromes like fibromyalgia and chronic fatigue syndrome. When clinicians are unable to diagnose disease or correlate symptoms with measurable changes in biomarkers, patients experiencing such an illness are at increased risk for suspicion, misplaced questioning, or having their motives misinterpreted through damaging social and cultural narratives about gender, race, ethnicity, socioeconomic status, or disability. Adhering strictly to a biomedical model of thinking about disease and diagnosis can prevent clinicians from empathically engaging with patients and helping them navigate their illness experiences.To claim one AMA PRA Category 1 Credit TM for the CME activity associated with this article, you must do the following: (1) read this article in its entirety, (2) answer at least 80 percent of the quiz questions correctly, and (3) complete an evaluation. The quiz, evaluation, and form for claiming AMA PRA Category 1 Credit TM are available through the AMA Ed Hub TM .

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“Even my sister says I'm acting like a crazy to get a check”: Race, gender, and moral boundary-work in women's claims of disabling chronic pain

Cited by 84 publications

References 26 publications

<p>The Effects of Racial/Ethnic Minority Status on Sleep, Mood Disturbance, and Depression in People with Fibromyalgia</p>

<p>The Effects of Racial/Ethnic Minority Status on Sleep, Mood Disturbance, and Depression in People with Fibromyalgia</p>

What the Doctors Don't See: Physicians as Gatekeepers, Injured Latino Immigrants, and Workers' Compensation System

Questioning Biomedicine's Privileging of Disease and Measurability

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