Disparities in Pain and Pain Care

  • Salimah H. MeghaniEmail author
  • Carmen Green


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, 2017; Atkins D, Perez-Stable EJ, Kilbourne AM, Medi Care 55(Suppl 9, Suppl 2):S6–S8,, 2017; HHS, 2 HHS action plan to reduce racial and ethnic health disparities: implementation progress report 2011–2014. Retrieved from, 2015; Lopez N, Gadsden VL, Health inequities, social determinants, and intersectionality. Perspectives: expert voices in health and healthcare. Retrieved from, 2016; Thornton RL, Glover CM, Cene CW, Glik DC, Henderson JA, Williams DR, Health Affairs (Millwood) 35(8):1416–1423., 2016; U.S. Department of Health and Human Services, Healthy people 2020: disparities. Retrieved from, 2017). Differences and disparities in health status and healthcare based upon social determinants persist (AHRQ, 2016 National healthcare quality and disparities report. Retrieved from, 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, 2017; CDC, Health, United States 2015: with special feature on racial and ethnic health disparities. Retrieved from, 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, 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.


Pain Pain assessment Pain treatment Disparities Race Ethnicity Gender Access Patient barriers Provider barriers System barriers Opioids Policy 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Biobehavioral Health Sciences, NewCourtland Center for Transitions and Health; Leonard Davis Institute of Health EconomicsUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Departments of Anesthesiology, Obstetrics and Gynecology, and Health Management and PolicyUniversity of MichiganAnn ArborUSA

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