Pain Interference, Psychopathology, and General Medical Conditions Among Black and White Adults in the US General Population

Abstract

Objectives To assess how race might moderate relationships between pain interference and psychopathology and general medical conditions among a nationally representative sample of black and white adults. Methods Chi-square tests and multivariable logistic regression analyses were performed on data from the National Epidemiologic Survey on Alcohol and Related Conditions on 32,474 adult respondents (25% black; 75% white), who were categorized according to one of three levels of pain interference (i.e., no/low, moderate, or severe). Results Pain interference was associated with race in bivariate analyses (p<.001); relative to white respondents, black respondents had lower rates of no/low pain interference (78.9% vs. 80.3%), lower rates of moderate pain interference (6.8% vs. 7.8%) and higher rates of severe pain interference (14.3% vs. 11.9%). Pain interference was associated with past-year Axis-I psychiatric disorders in both black and white respondents (p<0.001) with the largest odds typically observed in association with moderate or severe pain interference. A stronger relationship was observed in black as compared to white respondents between severe pain interference and any Axis-I disorder (OR=1.28, p<0.05) and alcohol abuse or dependence (OR=1.90, p<0.05), and between moderate pain interference and tachycardia (OR=1.69, p<0.05). In contrast, a weaker relationship was observed in black as compared to white respondents between moderate pain interference and any general medical condition (OR=0.70, p<0.05). Conclusions These findings underscore the complexity of race-related disparities in health and suggest the importance of further study of the possible mechanisms underlying the apparent differences between black and white groups in the relationships between pain interference, psychopathology, and general medical conditions.

Pain Intensity among Community-Dwelling African American Older Adults in an Economically Disadvantaged Area of Los Angeles: Social, Behavioral, and Health Determinants

“…We might expect a cyclical relationship such that people use these types of health behaviors in an attempt to dampen pain intensity, but increased frequency of these health behaviors, in turn, leads to other chronic issues and potentially increased pain [48,52]. Past research has demonstrated this association in AA populations [90,91], even showing a stronger relationship between pain and substance use for AAs compared to Whites [3,11].…”

“…Previous research has indicated a relationship between pain interference and alcohol abuse or alcohol-related problems that is stronger for AAs compared to Whites [3,11]. However, moderate alcohol consumption is related to pain reductions, suggesting a potential curvilinear relationship between moderate alcohol consumption and pain improvement but deleterious pain outcomes related to excessive drinking [48,52].…”

“…African American (AA) populations are at heightened risk for greater pain intensity, pain sensitivity, pain interference (i.e., the interruption of activities due to pain), and disability [8,9,10,11,12], which are among the main components of pain experiences [11,13,14]. However, AA adults are given less treatment for pain than their White counterparts [15,16].…”

“…Research has also often shown an association between alcohol and pain [3,48,49,51,52]. Furthermore, research has shown that this relationship may be particularly strong for AAs compared to Whites [3,11].…”

Racial Differences in the Relationship Between Pain and Suicide Desire in Older Adults

“…In addition to a greater proportion of Black older adults experiencing chronic pain, chronic pain disproportionately affects other components of Black older adults' lives. Compared to White older adults, Black older adults with chronic pain are more likely to experience pain interference in activities of daily living (Barry et al, 2017), be diagnosed with a pain-related disability (Janevic et al, 2017), and experience a greater degree of psychological distress and depression associated with chronic pain (Bierman & Lee, 2018). In a meta-analysis on racial differences in pain coping, Meints et al (2016) found Black adults were more likely than White adults to use pain coping strategies overall.…”