The association between experienced discrimination and pain in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study

Introduction: The relationship between experienced discrimination and its effects on pain interference and management among racial disparities is not well-explored. This research investigated these associations among Black and White U.S. adults.

Methods: Participants aged 45 and older from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study were assessed. A total of 6818 participants completed the 9-item Experiences of Discrimination questionnaire and reported pain interference based on the Short Form 12 (SF-12) questionnaire. The presence of pain medications was assessed following an in-home visit. Covariates considered included demographics, medical comorbidities, depression symptoms, perceived stress, and neighborhood cohesion. Logistic regression was utilized to examine associations.

Results: Black individuals reported experiencing more discrimination and, despite this, received pain treatment at a lower rate (64.1%) than White individuals in the overall sample and across both pain interference groups. High discrimination levels in Black participants correlated with a 28% greater odds of pain interference (aOR: 1.28, 95% CI: 1.00 – 1.65). In contrast, White participants with moderate and high discrimination had higher odds of pain interference by 31% (aOR: 1.31, 95% CI: 1.10 – 1.55) and 44% (aOR: 1.44, 95% CI: 1.14 – 1.83) respectively. Specific discrimination instances, such as at school or work, notably heightened White participants' pain interference. Moreover, Whites discriminated against during job hiring had a 47% decrease in the likelihood of receiving pain treatment (aOR: 0.53, 95% CI: 0.36 – 0.78).

Conclusion : Experienced discrimination correlates with increased pain interference among White and Black individuals and, in the case of both groups, may influence pain treatment. Furthermore, specific instances of discrimination are associated with pain interference and pain treatment for White participants. The relationship is less consistent for Black participants, warranting further investigation.