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Disparities in Pain and Pain Care

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Handbook of Pain and Palliative Care

Abstract

Social determinants such as race, ethnicity, class, age, gender identity, sexual orientation, disability, and geographic location are well-known predictors and indicators of overall health status (AHRQ, 2016 National healthcare quality and disparities report. Retrieved from http://www.ahrq.gov/research/findings/nhqrdr/nhqdr16/index.html, 2017; Atkins D, Perez-Stable EJ, Kilbourne AM, Medi Care 55(Suppl 9, Suppl 2):S6–S8, https://doi.org/10.1097/MLR.0000000000000783, 2017; HHS, 2 HHS action plan to reduce racial and ethnic health disparities: implementation progress report 2011–2014. Retrieved from https://minorityhealth.hhs.gov/assets/pdf/FINAL_HHS_Action_Plan_Progress_Report_11_2_2015.pdf, 2015; Lopez N, Gadsden VL, Health inequities, social determinants, and intersectionality. Perspectives: expert voices in health and healthcare. Retrieved from https://nam.edu/wp-content/uploads/2016/12/Health-Inequities-Social-Determinants-and-Intersectionality.pdf, 2016; Thornton RL, Glover CM, Cene CW, Glik DC, Henderson JA, Williams DR, Health Affairs (Millwood) 35(8):1416–1423. https://doi.org/10.1377/hlthaff.2015.1357, 2016; U.S. Department of Health and Human Services, Healthy people 2020: disparities. Retrieved from https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities, 2017). Differences and disparities in health status and healthcare based upon social determinants persist (AHRQ, 2016 National healthcare quality and disparities report. Retrieved from http://www.ahrq.gov/research/findings/nhqrdr/nhqdr16/index.html, 2017). Specifically, racial and ethnic minority and low-income individuals systematically experience social and economic disadvantages, greater burden of illness, and decreased life expectancy when compared to Caucasian-Americans (AHRQ, 2016 National healthcare quality and disparities report. Retrieved from http://www.ahrq.gov/research/findings/nhqrdr/nhqdr16/index.html, 2017; CDC, Health, United States 2015: with special feature on racial and ethnic health disparities. Retrieved from https://www.cdc.gov/nchs/data/hus/hus15.pdf, 2015). The overall physical, social, and emotional health for racial and ethnic minority Americans is consistently less than that of Caucasian-Americans even when their access to healthcare and health insurance coverage is similar (AHRQ, 2016 National healthcare quality and disparities report. Retrieved from http://www.ahrq.gov/research/findings/nhqrdr/nhqdr16/index.html, 2017; Institute of Medicine, Unequal treatment: confronting racial and ethnic disparities in health care. Washington, The National Academies Press, 2002). Within this larger context, the goal of this chapter is to provide information on pain care disparities.

“I’m aggressive about my [pain] treatment. I want to get well, so I had to tell one of the doctors, if I was your daughter or your wife, and I had to say this, if my skin color was different, then you would do everything that you possibly can to make sure that I was well. I say, treat me the same way.” (Meghani and Houldin 2007)

A 42-year-old woman with breast cancer

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Authors and Affiliations

  1. Department of Biobehavioral Health Sciences, NewCourtland Center for Transitions and Health; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA

    Salimah H. Meghani PhD, MBE, FAAN

  2. Departments of Anesthesiology, Obstetrics and Gynecology, and Health Management and Policy, University of Michigan, Ann Arbor, MI, USA

    Carmen Green MD

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  1. Salimah H. Meghani PhD, MBE, FAAN
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Correspondence to Salimah H. Meghani PhD, MBE, FAAN .

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    Rhonda J. Moore

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Meghani, S.H., Green, C. (2018). Disparities in Pain and Pain Care. In: Moore, R. (eds) Handbook of Pain and Palliative Care. Springer, Cham. https://doi.org/10.1007/978-3-319-95369-4_41

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