Socioeconomic and ethnic disparities in low back pain and physical function

      According to the American Chiropractic Association, over 30 million Americans have had low back pain at some point in their lives. The total cost of low back pain in 1986 was around $11.1 billion dollars. Previous researchers have uncovered disparities in the presentation and treatment of low back pain (or chronic pain), finding that African American individuals report more severe pain than Caucasian individuals. Subjects. Student research assistants enrolled 367 adult patients from 9 outpatient clinics across Texas. Procedure and Measurement. Students gathered data from patient surveys and medical records. A 6-page patient survey addressed demographic characteristics, pain duration, frequency and severity, physical functioning and general health, anxiety, depression, substance abuse, and risk for opioid misuse. In this study, 30.8% patients were Hispanic, 45.2% were Caucasian, and 23.9% were African American. 27.5% of the subjects were male and 71.9% were female. Out of the three racial groups, African Americans had the worst pain (p=.001), the worst role functioning score, (p=.019) and the worse physical function score (p=.079). See Figure 1, 2 and 3. Opioid usage did not differ significantly between ethnic groups and education levels. We found disparities by insurance status. Individuals with private insurance were much less likely than the rest of the sample to take opioids, while those on government insurance were very likely to use opioids for pain (p = .000). This study of patients with chronic low back pain demonstrated a clear difference between African Americans and other racial/ethnic groups. African Americans had significantly worse pain and role function. Insurance status and education, indicators of socioeconomic status, were associated with pain, function, and use of opioids, One interesting finding is that Caucasians and Hispanics have a very similar mean pain average, but Caucasians have a significantly lower role function score than Hispanics.