Perceived Racial Discrimination and Pain Intensity/Disability Among Economically Disadvantaged Latinos in a Federally Qualified Health Center: The Role of Anxiety Sensitivity

Abstract

The present study examined the role of anxiety sensitivity (AS; fear of the negative consequences of anxiety) in the relation between perceived racial discrimination and pain-related problems among Latinos seeking health services at a Federally Qualified Health Center. Participants included 145 adult Latinos (87.80% female, M = 38.07 years, SD = 11.98, and 96.2% reported Spanish as their first language). Results indicated that perceived racial discrimination was indirectly related to the pain intensity and pain disability through AS. These effects were evident above and beyond the variance accounted for by gender, age, marital status, educational status, employment status, years living in the United States, and number of axis I diagnoses. Overall, the present findings highlight the merit in focusing further scientific attention on the interplay between perceived racial discrimination and AS to better understand and inform interventions to reduce pain problems among Latinos in primary care.

Identifying healthcare experiences associated with perceptions of racial/ethnic discrimination among veterans with pain: A cross-sectional mixed methods survey

“…This mixed methods analysis used data from the DISC Study to identify aspects of patient experiences associated with perceived racial/ethnic discrimination in healthcare among a large, diverse sample of patients being treated for pain. It is important to understand experiences of perceived discrimination in healthcare settings for patients with pain, specifically, as experiences of discrimination have been linked to increased pain sensitivity, pain severity, disability, and development of chronic pain [8,9,[28][29][30][31]. In addition, there are well-documented racial/ethnic disparities in both the clinical impact and treatment of pain, for which discrimination may be a contributing factor [14,17,32].…”

Greater mechanical temporal summation of pain in Latinx-Americans and the role of adverse life experiences

“… 12 Even beyond laboratory pain testing studies, recent evidence suggests that perceived ethnic discrimination correlates significantly with greater clinical pain intensity ( r = 0.21) and pain disability ( r = 0.27) among Latinx individuals recruited from a government-subsidized community-based outpatient clinic. 6 However, Bakhshaie et al's (2019) study composed largely of non-U.S.-native participants (88.4%) who predominantly spoke Spanish as their first language (96.6%) and earned less than $14,999 per year (55.9%), 6 a contrast to the U.S.-native Latinx-Americans from higher household incomes assessed in the current study (Table 1 ). The stated hypotheses in the current study regarding the relationship between trauma and discrimination was derived from the aforementioned laboratory pain testing studies that assessed either a different ethnicity group (African Americans), a different trauma group (ie, stratified high vs low trauma), or a different setting (ie, community population).…”

“… 39 Moreover, 2 recent studies find that discrimination predicts greater clinical pain severity among Latinx-Americans. 6 , 23 Taken together, these studies implicate perceived racial/ethnic discrimination as a risk factor for greater central sensitization and clinical pain experiences in minoritized people of color. However, the relationship between ethnic discrimination and temporal summation of pain in Latinx-Americans remains unexplored.…”

“…Recent work would also suggest that heterogeneity within a minoritized population can also contribute to differences in clinical pain outcomes. 6 However, considering expected Latinx-American growth over decades in the United States, along with the unique histories and current sociopolitical realities experienced by Latinx-Americans and their subgroups (eg, Mexican, Central-American, South-American), it is important to evaluate the specific contexts (eg, regions, study settings, and socioeconomic status), cultures (eg, values, beliefs, histories, and nativity), and adversities (eg, trauma and discrimination) that may contribute to their pain experiences. Specifically, future studies must resist simple extrapolation from other groups.…”

<p>Chronic Noncancer Pain Management and Systemic Racism: Time to Move Toward Equal Care Standards</p>

“…122,123 Numerous studies have demonstrated a strong positive relationship between perceived racial and ethnic discrimination and pain intensity. [124][125][126][127][128][129][130][131][132][133][134][135][136] This is of particular importance, given the literature indicating that the experience of discrimination predicts inferior physical and mental health outcomes. [137][138][139] Not surprisingly, data also indicate a positive relationship between perceived injustice and pain severity as well as poorer pain outcomes among BIPOC compared to White patients.…”