Abstract
The purpose of our review is to evaluate critically the recent literature on racial
and ethnic disparities in pain and to determine how far we have come toward reducing
and eliminating disparities in pain. We examined peer-reviewed research articles published
between 1990 and early 2009 that focused on racial and ethnic disparities in pain
in the United States. The databases used were PubMed, Medline, Scopus, CINAHL, and
PsycInfo. The probable causes of minority group disparities in pain are discussed,
along with suggested strategies for eliminating pain-related disparities. This review
reveals the persistence of racial and ethnic disparities in acute, chronic, cancer,
and palliative pain care across the lifespan and treatment settings, with minorities
receiving lesser quality pain care than non-Hispanic whites. Although health and health
care disparities attract local, state, and federal attention, disparities in pain
care continue to be missing from publicized public health agendas and health care
reform plans. Ensuring optimal pain care for all is critically important from a public
health and policy perspective. A robust research program on disparities in pain is
needed, and the results must be successfully translated into practices and policies
specifically designed to reduce and eliminate disparities in care.
Perspective
This review evaluates the recent literature on racial and ethnic disparities in pain
and pain treatment. Racial and ethnic disparities in acute pain, chronic cancer pain,
and palliative pain care continue to persist. Rigorous research is needed to develop
interventions, practices, and policies for eliminating disparities in pain.
Key words
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References
- Prescribing and self-administration of morphine in Hispanic and non Hispanic Caucasian patients treated with patient-controlled analgesia.J Pain Palliat Care Pharmacother. 2004; 18: 29-38
- Pain education for underserved minority cancer patients: A randomized controlled trial.J Clin Oncol. 2004; 22: 4918-4925
- Minority cancer patients and their providers: Pain management attitudes and practice.Cancer. 2000; 88: 1929-1938
- Cancer pain management among underserved minority outpatients: Perceived needs and barriers to optimal control.Cancer. 2002; 94: 2295-2304
- Is there a difference in the perception of symptoms between African Americans and whites with osteoarthritis?.J Rheumatol. 2003; 30: 1305-1310
- Arthritis symptoms as indicators of pain in older African Americans.Ethn Dis. 2003; 13: 513-520
- Intrarace differences among black and white Americans presenting for chronic pain management: The influence of age, physical health, and psychosocial factors.Pain Med. 2005; 6: 29-38
- Physical functioning in older blacks: An exploratory study identifying psychosocial and clinical predictors.J Natl Med Assoc. 2006; 98: 1114-1120
- Physician and patient factors influencing the treatment of low back pain.Pain. 1997; 73: 209-211
- Ethnocultural influences on variation in chronic pain perception.Pain. 1993; 52: 101-112
- Control, culture and chronic pain.Soc Sci Med. 1994; 39: 629-645
- Management of pain in elderly patients with cancer. SAGE Study Group: Systematic Assessment of Geriatric Drug Use via Epidemiology.JAMA. 1998; 279: 1877-1882
- Race, ethnicity, and management of pain from long-bone fractures: A prospective study of two academic urban emergency departments.Acad Emerg Med. 2008; 15: 589-597
- No racial or ethnic disparity in treatment of long-bone fractures.Am J Emerg Med. 2008; 26: 270-274
- Race, ethnicity, and pain treatment: Striving to understand the causes and solutions to the disparities in pain treatment.J Law Med Ethics. 2001; 29: 52-68
- Race and racism.Oxford University Press, Oxford, UK2001
- En las manos de Dios [in God's hands]: Religious and other forms of coping among Latinos with arthritis.J Consult Clin Psychol. 2004; 72: 91-102
- Health status disparities in ethnic minority patients with rheumatoid arthritis: A cross-sectional study.J Rheumatol. 2007; 34: 1475-1479
- van RM, Crowley-Matoka M, Malat J: Understanding the provider contribution to race/ethnicity disparities in pain treatment: Insights from dual process models of stereotyping.Pain Med. 2006; 7: 119-134
- Ethnic differences in responses to multiple experimental pain stimuli.Pain. 2005; 113: 20-26
- Ethnic differences in diffuse noxious inhibitory controls.J Pain. 2008; 9: 759-766
- Ethnic differences in the nociceptive flexion reflex (NFR).Pain. 2008; 134: 91-96
- Relationship of ethnicity, gender, and ambulatory blood pressure to pain sensitivity: Effects of individualized pain rating scales.J Pain. 2004; 5: 183-191
- Coping, pain severity, interference, and disability: The potential mediating and moderating roles of race and education.J Pain. 2006; 7: 459-468
- The relation of race to outcomes and the use of health care services for acute low back pain.Spine. 2003; 28: 390-394
- Racial differences in pain during 1 year among women with metastatic breast cancer: A hazards analysis of interval-censored data.Cancer. 2008; 112: 162-170
- Racial/ethnic differences in the prevalence and impact of doctor-diagnosed arthritis: United States, 2002.MMWR. 2005; 54: 119-123
Center to Reduce Cancer Health Disparities: Researching and reducing cancer-related health disparities. Available at http://crchd.cancer.gov/disparities/defined.html. Accessed March 1, 2009
- Variations in cutaneous and visceral pain sensitivity in normal subjects.J Clin Invest. 1944; 23: 81-91
- Racial differences in opioid use for chronic nonmalignant pain.J Gen Intern Med. 2005; 20: 593-598
- Interventions to reduce racial and ethnic disparities in health care.Med Care Res Rev. 2007; 64: 7S-28S
- Ethnicity and prescription of analgesia in an accident and emergency department: Cross sectional study.BMJ. 2000; 320: 980-981
- Survival of Medicare patients after enrollment in hospice programs.N Engl J Med. 1996; 335: 172-178
- Pain and ethnicity in the United States: A systematic review.J Palliat Med. 2006; 9: 1454-1473
- Research in cancer pain: What we know and what we need to know.Cancer. 1991; 67: 823-827
- Pain and treatment of pain in minority patients with cancer: The Eastern Cooperative Oncology Group Minority Outpatient Pain Study.Ann Intern Med. 1997; 127: 813-816
- Pain and its treatment in outpatients with metastatic cancer.N Engl J Med. 1994; 330: 592-596
- Coping with toothache pain: A qualitative study of low-income persons and minorities.J Public Health Dent. 2007; 67: 28-35
- Family perspectives on the quality of pediatric palliative care.Arch Pediatr Adolesc Med. 2002; 156: 14-19
- Palliative and end-of-life care in the African American community.JAMA. 2000; 284: 2518-2521
- Racial and ethnic differences in osteoarthritis: Prevalence, outcomes, and medical care.Ethn Dis. 2004; 14: 558-566
- Patterns of opioid analgesic prescription among patients with osteoarthritis.J Pain Palliat Care Pharmacother. 2004; 18: 31-46
- Racial/ethnic variations in non-steroidal anti-inflammatory drug (NSAID) use among patients with osteoarthritis.Pharmacoepidemiol Drug Saf. 2004; 13: 683-694
- Race, ethnicity and pain.Pain. 2001; 94: 133-137
- Ethnic differences in pain tolerance: Clinical implications in a chronic pain population.Psychosom Med. 2001; 63: 316-323
- Ethnic differences in thermal pain responses.Psychosom Med. 1999; 61: 346-354
- Ethnic similarities and differences in the chronic pain experience: A comparison of African American, Hispanic, and white patients.Pain Med. 2005; 6: 88-98
- Enhancing Cancer Pain Control among American Indians (ECPCAI): A study of the Ojibwe of Minnesota.J Cancer Educ. 1999; 14: 28-33
- Racial inequities in the timing of breast cancer detection, diagnosis, and initiation of treatment.Med Care. 2005; 43: 141-148
- Post-treatment symptoms among ethnic minority breast cancer survivors.Oncol Nurs Forum. 2005; 32: 250-256
- Racial and ethnic disparities in pain management in the United States.J Nurs Scholarsh. 2006; 38: 225-233
- Shifting place of death among children with complex chronic conditions in the United States, 1989-2003.JAMA. 2007; 297: 2725-2732
- Individual differences in pain responses.Curr Rheumatol Rep. 2005; 7: 342-347
- Genetic contributions to pain: A review of findings in humans.Oral Dis. 2008; 14: 673-682
- Inequalities in racial access to health care.JAMA. 2000; 284: 2053
- Lack of ethnic differences in end-of-life care in the Veterans Health Administration.Am J Hosp Palliat Care. 2007; 24: 277-283
- Cultural leverage: Interventions using culture to narrow racial disparities in health care.Med Care Res Rev. 2007; 64: 243S-282S
- Palliative care in the inner city: Patient religious affiliation, underinsurance, and symptom attitude.Cancer. 2007; 109: 425-434
- Poverty, culture, and social injustice: Determinants of cancer disparities.CA Cancer J Clin. 2004; 54: 72-77
- Lack of association between patient ethnicity or race and fracture analgesia.Acad Emerg Med. 2002; 9: 910-915
- The association among neighborhood socioeconomic status, race and chronic pain in black and white older adults.J Natl Med Assoc. 2007; 99: 1160-1169
- Widespread pain and fibromyalgia in a biracial cohort of young women.J Rheumatol. 2007; 34: 810-817
- The uninsured: Problems, solutions, and the role of academic medicine.Acad Med. 2006; 81: 798-801
- US emergency department visits for hip fracture, 1992-2000.Eur J Emerg Med. 2004; 11: 323-328
- Triggers of uncertainty about recurrence and long-term treatment side effects in older African American and Caucasian breast cancer survivors.Oncol Nurs Forum. 2004; 31: 633-639
- Racial variations in self-reported osteoarthritis symptom severity among veterans.Aging Clin Exp Res. 2005; 17: 264-269
- Why genes don't count (for racial differences in health).Am J Public Health. 2000; 90: 1699-1702
- The healthcare bubble through the lens of pain research, practice, and policy: Advice for the new President and Congress.J Pain. 2008; 9: 1071-1073
- The unequal burden of pain: Confronting racial and ethnic disparities in pain.Pain Med. 2003; 4: 277-294
- Patient attitudes regarding healthcare utilization and referral: A descriptive comparison in African- and Caucasian Americans with chronic pain.J Natl Med Assoc. 2004; 96: 31-42
- Race and chronic pain: A comparative study of young black and white Americans presenting for management.J Pain. 2003; 4: 176-183
- The effect of race in older adults presenting for chronic pain management: A comparative study of black and white Americans.J Pain. 2003; 4: 82-90
- Consistent and breakthrough pain in diverse advanced cancer patients: A longitudinal examination.J Pain Symptom Manage. 2009; 37: 831-847
- Race, age, and gender influences among clusters of African American and white patients with chronic pain.J Pain. 2004; 5: 171-182
- Differences in prescription opioid analgesic availability: Comparing minority and white pharmacies across Michigan.J Pain. 2005; 6: 689-699
- Clinical decision making in pain management: Contributions of physician and patient characteristics to variations in practice.J Pain. 2003; 4: 29-39
- Coping strategies of HIV patients with peripheral neuropathy.AIDS Care. 2005; 17: 711-720
- Emergency medicine education and health care disparities.Acad Emerg Med. 2003; 10: 1189-1192
- Racial and ethnic differences in end-of-life costs: Why do minorities cost more than whites?.Arch Intern Med. 2009; 169: 493-501
- Ethnic differences and responses to pain in healthy young adults.Pain Med. 2005; 6: 61-71
- Institute of Medicine, Committee on Cancer Research among Minorities and the Medically Underserved: The unequal burden of cancer: An assessment of NIH research and programs for ethnic minorities and the medically underserved.National Academy Press, Washington, DC1999
- Disparities in analgesia and opioid prescribing practices for patients with musculoskeletal pain in the emergency department.J Emerg Nurs. 2006; 32: 219-224
- Prevalence, treatment, and control of chest pain syndromes and associated risk factors in hypertensive patients.Am J Hypertens. 2005; 18: 1026-1032
- Ethnic differences in pain reports and the moderating role of depression in a community sample of Hispanic and Caucasian participants with serious health problems.Psychosom Med. 2006; 68: 121-128
- Pain assessment and treatment disparities: A virtual human technology investigation.Pain. 2009; 143: 106-113
- Parenteral analgesic and sedative use among ED patients in the United States: Combined results from the National Hospital Ambulatory Medical Care Survey (NHAMCS) 1992-1997.Am J Emerg Med. 2002; 20: 139-143
- Promoting Health in Multicultural Populations: A Handbook for Practitioners.Sage Publications, Thousand Oaks, Calif1999
- The mountains hold things in: the use of community research review work groups to address cancer disparities in Appalachia.Oncol Nurs Forum. 2007; 34: 1133-1139
- Gender and ethnic differences in cancer pain experience: A multiethnic survey in the United States.Nurs Res. 2007; 56: 296-306
- African American cancer patients' pain experience.Cancer Nurs. 2008; 31: 38-46
- Ethnic variation in return to baseline values of patient-reported outcomes in older prostate cancer patients.Cancer. 2007; 109: 2229-2238
- Influence of race or ethnicity on pharmacokinetics of drugs.J Pharm Sci. 1997; 86: 1328-1333
- Predictability of the effects of race or ethnicity on pharmacokinetics of drugs.Int J Clin Pharmacol Ther. 2000; 38: 53-60
- The relationships of cognitive coping and pain control beliefs to pain and adjustment among African-American and Caucasian women with rheumatoid arthritis.Arthritis Care Res. 1998; 11: 80-88
- Influence of culture on cancer pain management in Hispanic patients.Cancer Pract. 1998; 6: 262-269
- Cultural considerations in education for cancer pain management.J Cancer Educ. 1999; 14: 168-173
- Can patient coaching reduce racial/ethnic disparities in cancer pain control? Secondary analysis of a randomized controlled trial.Pain Med. 2007; 8: 17-24
- “Lost to follow-up”: Ethnic disparities in continuity of hospice care at the end of life.J Palliat Med. 2005; 8: 603-608
- Analgesia for emergency centers' orthopaedic patients: Does an ethnic bias exist?.Clin Orthop Relat Res. 1997; 334: 270-275
- Comparing racial and ethnic populations based on Healthy People 2010 objectives.Healthy People Stat Notes. 2008; : 1-16
- Realizing the promise of breast cancer screening: Clinical follow-up after abnormal screening among black women.Prev Med. 2003; 37: 92-101
- Genetic influence on variability in human acute experimental pain sensitivity associated with gender, ethnicity and psychological temperament.Pain. 2004; 109: 488-496
- Race and histories of mood disorders modulate experimental pain tolerance in women.J Pain. 2007; 8: 861-868
- Encouraging Vietnamese-American women to obtain Pap tests through lay health worker outreach and media education.J Gen Intern Med. 2003; 18: 516-524
- Race, ethnicity, insurance coverage, and preoperative status of hip and knee surgical patients.J Arthroplasty. 2004; 19: 978-985
- Ethnic and sex differences in response to clinical and induced pain in chronic spinal pain patients.Spine. 1984; 9: 751-754
- Perceptual other-race training reduces implicit racial bias.PLoS ONE. 2009; 4: e4215
- What accounts for differences or disparities in pediatric palliative and end-of-life care? A systematic review focusing on possible multilevel mechanisms.Pediatrics. 2008; 122: 574-582
- Social cognition: Categorical person perception.Br J Psychol 92 Part. 2001; 1: 239-255
- A comparison of blacks and whites seeking treatment for chronic pain.Clin J Pain. 2001; 17: 249-255
- Gender and ethnic stereotyping and narcotic analgesic administration.Res Nurs Health. 1994; 17: 45-49
- Core outcome domains and measures for pediatric acute and chronic/recurrent pain clinical trials: PedIMMPACT recommendations.J Pain. 2008; 9: 771-783
- The hidden error of mismanaged pain: A systems approach.J Pain Symptom Manage. 2004; 28: 47-58
- African Americans show alterations in endogenous pain regulatory mechanisms and reduced pain tolerance to experimental pain procedures.Psychosom Med. 2005; 67: 948-956
- The meanings of and attitudes about cancer pain among African Americans.Oncol Nurs Forum. 2007; 34: 1179-1186
- Preference for analgesic treatment for cancer pain among African Americans.J Pain Symptom Manage. 2007; 34: 136-147
- Patient and physician perceptions as risk factors for oligoanalgesia: A prospective observational study of the relief of pain in the emergency department.Acad Emerg Med. 2006; 13: 140-146
- Cancer and breakthrough pain's impact on a diverse population.Pain Med. 2009; 10: 549-561
- “We don't carry that”: Failure of pharmacies in predominantly nonwhite neighborhoods to stock opioid analgesics.N Engl J Med. 2000; 342: 1023-1026
National Hospice and Palliative Care Organization: NHPCO facts and figures. Available at: http://www.nhpco.org/files/public/Statistics_Research/NHPCO_facts_and_figures.pdf. Accessed March 1, 2009
National Institutes of Health: NIH policy on reporting race and ethnicity data. Available at: http://grants.nih.gov/grants/guide/notice-files/NOT-OD-01-053.html. Accessed March 15, 2009
- Factors affecting emergency department opioid administration to severely injured patients.Acad Emerg Med. 2004; 11: 1290-1296
- Meta-analysis of survival in African American and white American patients with breast cancer: Ethnicity compared with socioeconomic status.J Clin Oncol. 2006; 24: 1342-1349
- The effect of ethnicity on prescriptions for patient-controlled analgesia for post-operative pain.Pain. 1996; 66: 9-12
- Ethnic differences in analgesic consumption for postoperative pain.Psychosom Med. 1996; 58: 125-129
- Access to care for chronic pain: racial and ethnic differences.J Pain. 2005; 6: 301-314
- Migraine care among different ethnicities: Do disparities exist?.Headache. 2006; 46: 754-765
- Revisions to the standards for the classification of federal data on race and ethnicity.Fed Reg. 1997; 62: 58781-58790
Otto M: For want of a dentist. Available at: http://www.washingtonpost.com/wp-dyn/content/article/2007/02/27/AR2007022702116.html. Accessed May 15, 2009
- Cultural heritage: Cancer screening and early detection.Semin Oncol Nurs. 1994; 10: 104-113
- Racially based disparities in pain management: Something old, something new, but what to do?.Pain Med. 2009; 10: 432-434
- Quality of life concerns in patients with breast cancer: Evidence for disparity of outcomes and experiences in pain management and palliative care among African-American women.Cancer. 2003; 97: 311-317
- Disparities in the emergency department evaluation of chest pain patients.Acad Emerg Med. 2007; 14: 149-156
- Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments.JAMA. 2008; 299: 70-78
- Socioeconomic disadvantage and pain.Pain. 2008; 136: 235-238
- Population-based survey of pain in the United States: Differences among white, African American, and Hispanic subjects.J Pain. 2004; 5: 317-328
- Are racial disparities in ED analgesia improving? Evidence from a national database.Am J Emerg Med. 2008; 26: 462-464
- Ethnic differences in pain among outpatients with terminal and end-stage chronic illness.Pain Med. 2005; 6: 235-241
- Ethnic identity predicts experimental pain sensitivity in African Americans and Hispanics.Pain. 2007; 129: 177-184
- Conquering cancer disparities: New opportunities for cancer epidemiology, biomarker, and prevention research.Cancer Epidemiol Biomarkers Prev. 2006; 15: 1569-1571
- Genetics, epidemiology, and cancer disparities: Is it black and white?.J Clin Oncol. 2006; 24: 2164-2169
- Hospice access and use by African Americans: Addressing cultural and institutional barriers through participatory action research.Soc Work. 1999; 44: 549-559
- Pain in aging community-dwelling adults in the United States: Non-Hispanic whites, non-Hispanic blacks, and Hispanics.J Pain. 2007; 8: 75-84
- Cytokine genes and pain severity in lung cancer: Exploring the influence of TNF-alpha-308 G/A IL6-174G/C and IL8-251T/A.Cancer Epidemiol Biomarkers Prev. 2007; 16: 2745-2751
- Disparities in pain management between cognitively intact and cognitively impaired nursing home residents.J Pain Symptom Manage. 2008; 35: 388-396
- Acculturation and orofacial pain among Hispanic adults.J Pain. 2008; 9: 750-758
- Racial differences in orofacial pain.J Pain. 2002; 3: 284-291
- Orofacial pain: Racial and sex differences among older adults.J Public Health Dent. 2002; 62: 132-139
- Socioeconomic and demographic disparities in symptoms of orofacial pain.J Public Health Dent. 2003; 63: 166-173
- Racial/ethnic differences in the experience of chronic pain.Pain. 2002; 100: 291-298
- Genetic structure of human populations.Science. 2002; 298: 2381-2385
- Comparing the experiential and psychosocial dimensions of chronic pain in African Americans and Caucasians: Findings from a national community sample.Pain Med. 2005; 6: 49-60
- Racial and ethnic disparities in the provision of epidural analgesia to Georgia Medicaid beneficiaries during labor and delivery.Am J Obstet Gynecol. 2004; 191: 456-462
- Racial and ethnic disparities in the receipt of cancer treatment.J Natl Cancer Inst. 2002; 94: 334-357
- Racial/ethnic variation in clinical presentation, treatment, and survival among breast cancer patients under age 35.Cancer. 2003; 97: 134-147
- Racial/ethnic patterns of care for cancers of the oral cavity, pharynx, larynx, sinuses, and salivary glands.Cancer Metastasis Rev. 2003; 22: 25-38
- Race and sex differences in cutaneous pain perception.Psychosom Med. 2000; 62: 517-523
- Pain scores improve analgesic administration patterns for trauma patients in the emergency department.Acad Emerg Med. 2004; 11: 264-270
- National analgesia prescribing patterns in emergency department patients with burns.J Burn Care Rehabil. 2002; 23: 361-365
- The influence of income and race on total knee arthroplasty in the United States.J Bone Joint Surg Am. 2006; 88: 2159-2166
- Institute of Medicine, Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care: Unequal treatment: Confronting racial and ethnic disparities in health care.National Academy Press, Washington, DC2003
- Racial disparities in receipt of hip and knee joint replacements are not explained by need: The Health and Retirement Study 1998-2004.J Gerontol A Biol Sci Med Sci. 2008; 63: 629-634
- Management of occupational back injuries: Differences among African Americans and Caucasians.Pain. 2004; 112: 389-396
- Disability determination: Validity with occupational low back pain.J Pain. 2006; 7: 951-957
- The effect of race/ethnicity and desirable social characteristics on physicians' decisions to prescribe opioid analgesics.Acad Emerg Med. 2003; 10: 1239-1248
- Racial and ethnic disparities in emergency department analgesic prescription.Am J Public Health. 2003; 93: 2067-2073
- Ethnicity, control appraisal, coping, and adjustment to chronic pain among black and white Americans.Pain Med. 2005; 6: 18-28
- Differences in the work-up and treatment of conditions associated with low back pain by patient gender and ethnic background.Spine. 2005; 30: 359-364
- Ethnicity and analgesic practice.Ann Emerg Med. 2000; 35: 11-16
- The effect of ethnicity on physician estimates of pain severity in patients with isolated extremity trauma.JAMA. 1994; 271: 925-928
- Ethnicity as a risk factor for inadequate emergency department analgesia.JAMA. 1993; 269: 1537-1539
- Formation of morphine from codeine in Chinese subjects of different CYP2D6 genotypes.Clin Pharmacol Ther. 1996; 60: 177-182
US Census Bureau: US Interim Projections by Age, Sex, Race, and Hispanic Origin: 2000-2050. Available at: http://www.census.gov/ipc/www/usinterimproj/. Accessed February 12, 2009
- Healthy people 2010. Understanding and improving health.US Department of Health and Human Services, Bethesda, MD2000
- Oral health in America: A report of the Surgeon General.US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, Rockville, MD2000
- Disparities between black and white patients with cancer pain: The effect of perception of control over pain.Pain Med. 2005; 6: 242-250
- Research on the provider contribution to race/ethnicity disparities in medical care.Med Care. 2002; 40: I140-I151
- The use of conscious sedation for pain control during forearm fracture reduction in children: Does race matter?.J Pediatr Orthop. 2006; 26: 53-57
- Sociodemographic correlates of tooth pain among adults: United States, 1989.Pain. 2000; 85: 87-92
- Physician attitudes and practice in cancer pain management: A survey from the Eastern Cooperative Oncology Group.Ann Intern Med. 1993; 119: 121-126
- Normative model for cold pressor test.Am J Phys Med Rehabil. 1989; 68: 6-11
- Cancer disparities by race/ethnicity and socioeconomic status.CA Cancer J Clin. 2004; 54: 78-93
- Patient-related barriers to management of cancer pain.Pain. 1993; 52: 319-324
- Patient-related barriers to management of cancer pain in Puerto Rico.Pain. 1994; 58: 233-238
- The influence of experimenter gender and race on pain reporting: Does racial or gender concordance matter?.Pain Med. 2005; 6: 80-87
- Do gender and race affect decisions about pain management?.J Gen Intern Med. 2001; 16: 211-217
- Race matters.Vintage, New York1994
- Moving upstream: how interventions that address the social determinants of health can improve health and reduce disparities.J Public Health Manag Pract. 2008; 14: S8-17
- The concept of race and health status in America.Public Health Rep. 1994; 109: 26-41
- The medicalization of race: Scientific legitimization of a flawed social construct.Ann Intern Med. 1996; 125: 675-679
- Assessment of pain in rheumatoid arthritis: minimal clinically significant difference, predictors, and the effect of anti-tumor necrosis factor therapy.J Rheumatol. 2007; 34: 1674-1683
- Pain tolerance: Differences according to age, sex and race.Psychosom Med. 1972; 34: 548-556
- Differences in clinical status measures in different ethnic/racial groups with early rheumatoid arthritis: Implications for interpretation of clinical trial data.J Rheumatol. 2007; 34: 311-315
- Effect of ethnicity and race on the use of pain medications in children with long bone fractures in the emergency department.Ann Emerg Med. 2003; 42: 41-47
- Ethnic differences in response to morphine.Clin Pharmacol Ther. 1993; 54: 507-513
Article Info
Footnotes
Editor's Note: This article is the last in a series of invited Critical Review articles designed to celebrate The Journal of Pain's 10th year anniversary of publication.
Supported by American Cancer Society grant RSGT-05-219-01-CPPB .
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© 2009 American Pain Society. Published by Elsevier Inc. All rights reserved.
