Top

Published in:

01-10-2008

The association of perceived discrimination with low back pain

Author: Robert R. Edwards

Published in: Journal of Behavioral Medicine | Issue 5/2008

Abstract

A handful of recent studies have documented perceived discrimination as a correlate of poor physical and mental health status among ethnic and racial minority groups. To date, however, despite a proliferation of research on ethnic disparities in the severity and impact of a number of persistent pain conditions, there have been no reports on associations between perceived discrimination and pain-related symptoms. Using data from a national survey (the National Survey of Midlife Development in the United States; MIDUS), we explore the relationships between perceived discriminatory events and the report of back pain among African-American and white men and women. As expected, African-American participants reported substantially greater perceptions of discrimination than white participants. Moreover, in models that included a variety of physical and mental health variables, episodes of major lifetime discriminatory events were the strongest predictors of back pain report in African-Americans, and perceived day-to-day discrimination was the strongest predictor of back pain report specifically in African-American women. Among white participants, perceptions of discrimination were minimally related or unrelated to back pain. To our knowledge, these are the first data documenting an association between perceived discrimination and report of back pain; the fact that perceptions of discrimination were stronger predictors than physical health variables highlights the potential salience and adverse impact of perceived discrimination in ethnic and racial minority groups.

Amaro, H., & Zambrana, R. E. (2000). Criollo, mestizo, mulato, latinegro, indigena, white, or black? The US Hispanic/Latino population and multiple responses in the 2000 census. American Journal of Public Health, 90, 1724–1727.PubMedCrossRef

Anderson, K. O., Mendoza, T. R., Valero, V., Richman, S. P., Russell, C., Hurley, J., et al. (2000). Minority cancer patients and their providers: Pain management attitudes and practice. Cancer, 88, 1929–1938. doi:10.1002/(SICI)1097-0142(20000415)88:8≤1929::AID-CNCR23≥3.0.CO;2-2.PubMedCrossRef

Ang, D. C., Ibrahim, S. A., Burant, C. J., Siminoff, L. A., & Kent, K. C. (2002). Ethnic differences in the perception of prayer and consideration of joint arthroplasty. Medical Care, 40, 471–476. doi:10.1097/00005650-200206000-00004.PubMedCrossRef

Banks, K. H., Kohn-Wood, L. P., & Spencer, M. (2006). An examination of the African American experience of everyday discrimination and symptoms of psychological distress. Community Mental Health Journal, 42, 555–570. doi:10.1007/s10597-006-9052-9.PubMedCrossRef

Brage, S., Sandanger, I., & Nygard, J. F. (2007). Emotional distress as a predictor for low back disability: A prospective 12-year population-based study. Spine, 32, 269–274. doi:10.1097/01.brs.0000251883.20205.26.PubMedCrossRef

Brawley, O. W. (1998). Prostate cancer and black men. Seminars in Urologic Oncology, 16, 184–186.PubMed

Brim, O., Baltes, P., Bumpass, L., Cleary, P., Featherman, D., Hazzard, W., et al. (2000). National SAurvey of Midlife Development in the United States 1995–6, Inter-University Consortium for Political and Social Research.

Brody, G. H., Chen, Y. F., Murry, V. M., Ge, X., Simons, R. L., Gibbons, F. X., et al. (2006). Perceived discrimination and the adjustment of African American youths: A five-year longitudinal analysis with contextual moderation effects. Child Development, 77, 1170–1189. doi:10.1111/j.1467-8624.2006.00927.x.PubMedCrossRef

Brondolo, E., Thompson, S., Brady, N., Appel, R., Cassells, A., Tobin, J. N., et al. (2005). The relationship of racism to appraisals and coping in a community sample. Ethnicity and Disease, 15, S5–S9.PubMed

Brooks, P. M. (2006). The burden of musculoskeletal disease––a global perspective. Clinical Rheumatology, 25, 778–781. doi:10.1007/s10067-006-0240-3.PubMedCrossRef

Broudy, R., Brondolo, E., Coakley, V., Brady, N., Cassells, A., Tobin, J. N., et al. (2007). Perceived ethnic discrimination in relation to daily moods and negative social interactions. Journal of Behavioral Medicine, 30, 31–43. doi:10.1007/s10865-006-9081-4.PubMedCrossRef

Bruehl, S., Chung, O. Y., & Burns, J. W. (2006a). Anger expression and pain: An overview of findings and possible mechanisms. Journal of Behavioral Medicine, 29, 593–606. doi:10.1007/s10865-006-9060-9.PubMedCrossRef

Bruehl, S., Chung, O. Y., & Burns, J. W. (2006b). Trait anger and blood pressure recovery following acute pain: Evidence for opioid-mediated effects. International Journal of Behavioral Medicine, 13, 138–146. doi:10.1207/s15327558ijbm1302_5.PubMedCrossRef

Bruehl, S., Chung, O. Y., Burns, J. W., & Biridepalli, S. (2003). The association between anger expression and chronic pain intensity: Evidence for partial mediation by endogenous opioid dysfunction. Pain, 106, 317–324. doi:10.1016/S0304-3959(03)00319-1.PubMedCrossRef

Bruehl, S., Chung, O. Y., Burns, J. W., & Diedrich, L. (2007). Trait anger expressiveness and pain-induced beta-endorphin release: Support for the opioid dysfunction hypothesis. Pain, 130(3), 208–215.PubMedCrossRef

Burns, J. W. (2006). Arousal of negative emotions and symptom-specific reactivity in chronic low back pain patients. Emotion (Washington, D.C.), 6, 309–319. doi:10.1037/1528-3542.6.2.309.

Burns, J. W., Bruehl, S., & Quartana, P. J. (2006). Anger management style and hostility among patients with chronic pain: Effects on symptom-specific physiological reactivity during anger- and sadness-recall interviews. Psychosomatic Medicine, 68, 786–793. doi:10.1097/01.psy.0000238211.89198.e4.PubMedCrossRef

Campbell, C. M., Edwards, R. R., & Fillingim, R. B. (2005). Ethnic differences in responses to multiple experimental pain stimuli. Pain, 113, 20–26. doi:10.1016/j.pain.2004.08.013.PubMedCrossRef

Carey, T. S., & Garrett, J. M. (2003). The relation of race to outcomes and the use of health care services for acute low back pain. Spine, 28, 390–394. doi:10.1097/00007632-200302150-00016.PubMedCrossRef

Casagrande, S. S., Gary, T. L., LaVeist, T. A., Gaskin, D. J., & Cooper, L. A. (2007). Perceived discrimination and adherence to medical care in a racially integrated community. Journal of General Internal Medicine, 22, 389–395. doi:10.1007/s11606-006-0057-4.PubMedCrossRef

Clark, R., Anderson, N. B., Clark, V. R., & Williams, D. R. (1999). Racism as a stressor for African Americans. A biopsychosocial model. The American Psychologist, 54, 805–816. doi:10.1037/0003-066X.54.10.805.PubMedCrossRef

Danielsson, A. J., & Nachemson, A. L. (2003). Back pain and function 22 years after brace treatment for adolescent idiopathic scoliosis: A case-control study-part I. Spine, 28, 2078–2085. doi:10.1097/01.BRS.0000084268.77805.6F.PubMedCrossRef

Dionne, C. E. (2005). Psychological distress confirmed as predictor of long-term back-related functional limitations in primary care settings. Journal of Clinical Epidemiology, 58, 714–718. doi:10.1016/j.jclinepi.2004.12.005.PubMedCrossRef

Dyrbye, L. N., Thomas, M. R., Eacker, A., Harper, W., Massie, F. S., Jr, Power, D. V., et al. (2007). Race, ethnicity, and medical student well-being in the United States. Archives of Internal Medicine, 167, 2103–2109. doi:10.1001/archinte.167.19.2103.PubMedCrossRef

Edwards, R. R., Bingham, C. O., III, Bathon, J., & Haythornthwaite, J. A. (2006a). Catastrophizing and pain in arthritis, fibromyalgia, and other rheumatic diseases. Arthritis and Rheumatism, 55, 325–332. doi:10.1002/art.21865.PubMedCrossRef

Edwards, R. R., Doleys, D. M., Fillingim, R. B., & Lowery, D. (2001a). Ethnic differences in pain tolerance: Clinical implications in a chronic pain population. Psychosomatic Medicine, 63, 316–323.PubMed

Edwards, R. R., & Fillingim, R. B. (1999). Ethnic differences in thermal pain responses. Psychosomatic Medicine, 61, 346–354.PubMed

Edwards, C. L., Fillingim, R. B., & Keefe, F. (2001b). Race, ethnicity and pain. Pain, 94, 133–137. doi:10.1016/S0304-3959(01)00408-0.PubMedCrossRef

Edwards, R. R., Goble, L., Kwan, A., Kudel, I., McGuire, L., Heinberg, L., et al. (2006b). Catastrophizing, pain, and social adjustment in scleroderma: Relationships with educational level. The Clinical Journal of Pain, 22, 639–646. doi:10.1097/01.ajp. 0000210918.26159.94.PubMedCrossRef

Edwards, R. R., Moric, M., Husfeldt, B., Buvanendran, A., & Ivankovich, O. (2005). Ethnic similarities and differences in the chronic pain experience: A comparison of African American, Hispanic, and white patients. Pain Medicine, 6, 88–98. doi:10.1111/j.1526-4637.2005.05007.x.PubMedCrossRef

Enthoven, P., Skargren, E., Carstensen, J., & Oberg, B. (2006). Predictive factors for 1-year and 5-year outcome for disability in a working population of patients with low back pain treated in primary care. Pain, 122, 137–144. doi:10.1016/j.pain.2006.01.022.PubMedCrossRef

Gee, G. C., Spencer, M. S., Chen, J., & Takeuchi, D. (2007). A nationwide study of discrimination and chronic health conditions among Asian Americans. American Journal of Public Health, 97, 1275–1282. doi:10.2105/AJPH.2006.091827.PubMedCrossRef

Gifford, A. L., Collins, R., Timberlake, D., Schuster, M. A., Shapiro, M. F., Bozzette, S. A., et al. (2000). Propensity of HIV patients to seek urgent and emergent care. HIV cost and services utilization study consortium. Journal of General Internal Medicine, 15, 833–840. doi:10.1046/j.1525-1497.2000.91136.x.PubMedCrossRef

Green, C. R., Anderson, K. O., Baker, T. A., Campbell, L. C., Decker, S., Fillingim, R. B., et al. (2003). The unequal burden of pain: Confronting racial and ethnic disparities in pain. Pain Medicine, 4, 277–294. doi:10.1046/j.1526-4637.2003.03034.x.

Harrell, J. P., Hall, S., & Taliaferro, J. (2003). Physiological responses to racism and discrimination: An assessment of the evidence. American Journal of Public Health, 93, 243–248.PubMedCrossRef

Hastie, B. A., Riley, J. L., & Fillingim, R. B. (2005). Ethnic differences and responses to pain in healthy young adults. Pain Medicine, 6, 61–71. doi:10.1111/j.1526-4637.2005.05009.x.PubMedCrossRef

Jakobsson, U., & Hallberg, I. R. (2002). Pain and quality of life among older people with rheumatoid arthritis and/or osteoarthritis: A literature review. Journal of Clinical Nursing, 11, 430–443. doi:10.1046/j.1365-2702.2002.00624.x.PubMedCrossRef

Jordan, M. S., Lumley, M. A., & Leisen, J. C. (1998). The relationships of cognitive coping and pain control beliefs to pain and adjustment among African-American and Caucasian women with rheumatoid arthritis. Arthritis Care and Research, 11, 80–88. doi:10.1002/art.1790110203.PubMedCrossRef

Katz, J. N. (2006). Lumbar disc disorders and low-back pain: Socioeconomic factors and consequences. The Journal of Bone and Joint Surgery. American Volume, 88(Suppl 2), 21–24. doi:10.2106/JBJS.E.01273.

Keefe, F. J., Abernethy, A. P., & Campbell, C. (2005). Psychological approaches to understanding and treating disease-related pain. Annual Review of Psychology, 56, 601–630. doi:10.1146/annurev.psych.56.091103.070302.PubMedCrossRef

Keefe, F. J., Rumble, M. E., Scipio, C. D., Giordano, L. A., & Perri, L. M. (2004). Psychological aspects of persistent pain: Current state of the science. Journal of Pain, 5, 195–211. doi:10.1016/j.jpain.2004.02.576.PubMedCrossRef

Keefe, F. J., Smith, S. J., Buffington, A. L., Gibson, J., Studts, J. L., & Caldwell, D. S. (2002). Recent advances and future directions in the biopsychosocial assessment and treatment of arthritis. Journal of Consulting and Clinical Psychology, 70, 640–655. doi:10.1037/0022-006X.70.3.640.PubMedCrossRef

Kessler, R. C., DuPont, R. L., Berglund, P., & Wittchen, H. U. (1999). Impairment in pure and comorbid generalized anxiety disorder and major depression at 12 months in two national surveys. The American Journal of Psychiatry, 156, 1915–1923.PubMed

Landrine, H., & Klonoff, E. A. (2000). Racial discrimination and cigarette smoking among Blacks: Findings from two studies. Ethnicity and Disease, 10, 195–202.PubMed

Latthe, P., Latthe, M., Say, L., Gulmezoglu, M., & Khan, K. S. (2006). WHO systematic review of prevalence of chronic pelvic pain: A neglected reproductive health morbidity. BMC Public Health, 6, 177. doi:10.1186/1471-2458-6-177.PubMedCrossRef

Lee, H., Bahler, R., Chung, C., Alonzo, A., & Zeller, R. A. (2000). Prehospital delay with myocardial infarction: The interactive effect of clinical symptoms and race. Applied Nursing Research, 13, 125–133. doi:10.1053/apnr.2000.7652.PubMedCrossRef

Levin, S., Sinclair, S., Veniegas, R. C., & Taylor, P. L. (2002). Perceived discrimination in the context of multiple group memberships. Psychological Science, 13, 557–560. doi:10.1111/1467-9280.00498.PubMedCrossRef

Linton, S. J. (2005). Do psychological factors increase the risk for back pain in the general population in both a cross-sectional and prospective analysis? European Journal of Pain (London, England), 9, 355–361. doi:10.1016/j.ejpain.2004.08.002.

List, J. M. (2005). Histories of mistrust and protectionism: Disadvantaged minority groups and human-subject research policies. The American Journal of Bioethics, 5, 53–56. doi:10.1080/15265160590927741.PubMedCrossRef

Macfarlane, G. J., McBeth, J., & Silman, A. J. (2001). Widespread body pain and mortality: Prospective population based study. BMJ (Clinical Research Ed.), 323, 662–665. doi:10.1136/bmj.323.7314.662.

Mays, V. M., & Cochran, S. D. (2001). Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 91, 1869–1876.PubMed

Mays, V. M., Cochran, S. D., & Barnes, N. W. (2007). Race, race-based discrimination, and health outcomes among African Americans. Annual Review of Psychology, 58, 201–225. doi:10.1146/annurev.psych.57.102904.190212.PubMedCrossRef

McBeth, J., Silman, A. J., & Macfarlane, G. J. (2003). Association of widespread body pain with an increased risk of cancer and reduced cancer survival: A prospective, population-based study. Arthritis and Rheumatism, 48, 1686–1692. doi:10.1002/art.10973.PubMedCrossRef

McCracken, L. M., & Eccleston, C. (2005). A prospective study of acceptance of pain and patient functioning with chronic pain. Pain, 118, 164–169. doi:10.1016/j.pain.2005.08.015.PubMedCrossRef

McCracken, L. M., & Vowles, K. E. (2006). Acceptance of chronic pain. Current Pain and Headache Reports, 10, 90–94. doi:10.1007/s11916-006-0018-y.PubMedCrossRef

McCracken, L. M., Vowles, K. E., & Gauntlett-Gilbert, J. (2007). A prospective investigation of acceptance and control-oriented coping with chronic pain. Journal of Behavioral Medicine, 30, 339–349. doi:10.1007/s10865-007-9104-9.PubMedCrossRef

McWilliams, L. A., Goodwin, R. D., & Cox, B. J. (2004). Depression and anxiety associated with three pain conditions: Results from a nationally representative sample. Pain, 111, 77–83. doi:10.1016/j.pain.2004.06.002.PubMedCrossRef

Noh, S., Kaspar, V., & Wickrama, K. A. (2007). Overt and subtle racial discrimination and mental health: Preliminary findings for Korean immigrants. American Journal of Public Health, 97, 1269–1274. doi:10.2105/AJPH.2005.085316.PubMedCrossRef

Norris, C. M., Ghali, W. A., Saunders, L. D., Brant, R., Galbraith, D., Faris, P., et al. (2006). Ordinal regression model and the linear regression model were superior to the logistic regression models. Journal of Clinical Epidemiology, 59, 448–456. doi:10.1016/j.jclinepi.2005.09.007.PubMedCrossRef

Piette, J. D., Bibbins-Domingo, K., & Schillinger, D. (2006). Health care discrimination, processes of care, and diabetes patients’ health status. Patient Education and Counseling, 60, 41–48. doi:10.1016/j.pec.2004.12.001.PubMedCrossRef

Rahim-Williams, F. B., Riley, J. L., III, Herrera, D., Campbell, C. M., Hastie, B. A., & Fillingim, R. B.(2007). Ethnic identity predicts experimental pain sensitivity in African Americans and Hispanics. Pain, 129(1–2), 177–184.

Reddy, S., Shapiro, M., Morton, R., Jr., & Brawley, O. W. (2003). Prostate cancer in black and white Americans. Cancer and Metastasis Reviews, 22, 83–86. doi:10.1023/A:1022216119066.PubMedCrossRef

Rogers, A., & Allison, T. (2004). What if my back breaks? Making sense of musculoskeletal pain among South Asian and African-Caribbean people in the North West of England. Journal of Psychosomatic Research, 57, 79–87. doi:10.1016/S0022-3999(03)00570-1.PubMedCrossRef

Schouten, B. C., & Meeuwesen, L. (2006). Cultural differences in medical communication: A review of the literature. Patient Education and Counseling, 64, 21–34. doi:10.1016/j.pec.2005.11.014.PubMedCrossRef

Shavers, V. L., & Shavers, B. S. (2006). Racism and health inequity among Americans. Journal of the National Medical Association, 98, 386–396.PubMed

Siefert, K., Finlayson, T. L., Williams, D. R., Delva, J., & Ismail, A. I. (2007). Modifiable risk and protective factors for depressive symptoms in low-income African American mothers. The American Journal of Orthopsychiatry, 77, 113–123. doi:10.1037/0002-9432.77.1.113.PubMedCrossRef

Smith, M. T., Edwards, R. R., Robinson, R. C., & Dworkin, R. H. (2004). Suicidal ideation, plans, and attempts in chronic pain patients: Factors associated with increased risk. Pain, 111, 201–208. doi:10.1016/j.pain.2004.06.016.PubMedCrossRef

Taylor, T. R., Williams, C. D., Makambi, K. H., Mouton, C., Harrell, J. P., Cozier, Y., et al. (2007). Racial discrimination and breast cancer incidence in US Black women: The Black women’s health study. American Journal of Epidemiology, 166, 46–54. doi:10.1093/aje/kwm056.PubMedCrossRef

Thapa, S. B., & Hauff, E. (2005). Gender differences in factors associated with psychological distress among immigrants from low- and middle-income countries––findings from the Oslo Health Study. Social Psychiatry and Psychiatric Epidemiology, 40, 78–84. doi:10.1007/s00127-005-0855-8.PubMedCrossRef

Thomas, K. S., Bardwell, W. A., Ancoli-Israel, S., & Dimsdale, J. E. (2006). The toll of ethnic discrimination on sleep architecture and fatigue. Health Psychology, 25, 635–642. doi:10.1037/0278-6133.25.5.635.PubMedCrossRef

Turk, D. C. (1996). Biopsychosocial perspective on chronic pain. In R. J. Gatchel & D. C. Turk (Eds.), Psychological approaches to pain management: A practitioner’s handbook (pp. 3–32). New York: Guilford Press.

Turk, D. C. (2002). Chronic non-malignant pain patients and health economic consequences. European Journal of Pain (London, England), 6, 353–355. doi:10.1016/S1090-3801(02)00024-1.

Wamala, S., Bostrom, G., & Nyqvist, K. (2007a). Perceived discrimination and psychological distress in Sweden. The British Journal of Psychiatry, 190, 75–76. doi:10.1192/bjp.bp.105.021188.PubMedCrossRef

Wamala, S., Merlo, J., Bostrom, G., & Hogstedt, C. (2007b). Perceived discrimination, socioeconomic disadvantage and refraining from seeking medical treatment in Sweden. Journal of Epidemiology and Community Health, 61, 409–415. doi:10.1136/jech.2006.049999.PubMedCrossRef

Wang, P. S., Berglund, P., & Kessler, R. C. (2000). Recent care of common mental disorders in the United States: Prevalence and conformance with evidence-based recommendations. Journal of General Internal Medicine, 15, 284–292. doi:10.1046/j.1525-1497.2000.9908044.x.PubMedCrossRef

Williams, D. R. (1999). Race, socioeconomic status, and health. The added effects of racism and discrimination. Annals of the New York Academy of Sciences, 896, 173–188. doi:10.1111/j.1749-6632.1999.tb08114.x.PubMedCrossRef

Williams, D. R., Neighbors, H. W., & Jackson, J. S. (2003). Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 93, 200–208.PubMedCrossRef

Title: The association of perceived discrimination with low back pain
Author: Robert R. Edwards
Publication date: 01-10-2008
Publisher: Springer US
Published in: Journal of Behavioral Medicine / Issue 5/2008
Print ISSN: 0160-7715
Electronic ISSN: 1573-3521
DOI: https://doi.org/10.1007/s10865-008-9160-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The association of perceived discrimination with low back pain

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2008

Social influence and pain response in women and men

Optimism, social support, and adjustment in African American women with breast cancer

Depression predicts failure to complete phase-II cardiac rehabilitation

Factorial invariance of child self-report across socioeconomic status groups: a multigroup confirmatory factor analysis utilizing the PedsQLTM 4.0 Generic Core Scales

Relationship of race-, sexual orientation-, and HIV-related discrimination with adherence to HIV treatment: a pilot study

Motivational interviewing fails to improve outcomes of a behavioral weight loss program for obese African American women: a pilot randomized trial