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Penn School of Nursing researchers found that acute injury characteristics are strongly associated with racial and ethnic differences in chronic pain. Credit: Kylie Cooper

Researchers at the School of Nursing found that injury-related factors may be the driving influence behind racial and ethnic disparities in chronic pain. 

The study, published in the journal Injury Prevention, examined factors that could theoretically affect varying chronic pain outcomes between patients of different races and ethnicities. Based on data from 650 participants, the researchers found that acute injury characteristics were most strongly associated with differences in chronic pain outcomes. 

Chronic pain is a leading cause of disability globally. While past research has highlighted racial and ethnic disparities in pain treatment, the specific factors influencing the emergence of chronic pain have gone unexplored. Penn Nursing professors Therese Richmond and Sara Jacoby and researchers from RAND Corporation and Baylor University Medical Center investigated possible influences on how chronic pain develops after an injury. 

The study enrolled 650 adult participants, representing diverse racial and ethnic backgrounds, from two Level 1 trauma centers in Pennsylvania and Texas. Researchers collected data from medical records and surveys shortly after injury, three months later, and finally at the 12-month mark.  

They found the closest tie between chronic pain disparities and injury-related factors such as injury type, severity, pain experienced during hospitalization, and length of hospital stay. Black participants, who reported the highest average chronic pain severity after injury, were disproportionately injured due to violence compared to their white and Hispanic counterparts.

Racial differences in healthcare outcomes are well-documented. A 2021 study by Penn researchers found a racial disparity in avoidable hospitalizations across Medicare plans. Also, in 2021, city officials expressed concern over the disparity in vaccination rates among young Philadelphians. 

Jacoby told Penn Today that stereotypes and stigma can affect patients' treatment for acute pain. 

“I think that the takeaway, for me, was that you can’t take prevention out of the picture when thinking about intervening on racialized disparities in long-term recovery,” Jacoby said. 

Richmond said that the equitable treatment of pain is the second-best targeted response to address these inequities. 

“The absolute best-targeted response is to prevent the injury from happening, and that is our responsibility,” she said.

Richmond added that the study leaves room for more investigation into other factors that could explain disparities in chronic pain outcomes.