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Where pain lives: Managing chronic pain tougher in poor neighborhoods

Living in a poor neighborhood was linked with worse chronic pain for young adults, according to a study by the University of Michigan Health System, but young black patients faced difficulties with pain management no matter where they lived.

With the study, the University of Michigan researchers have opened a new frontier in addressing chronic pain in America.

The results were published in a recent issue of The Journal of Pain and showed where a patient lives, its structural barriers, affluence, and access to resources such as pain medicines, play an important role in pain management.

"Acknowledging the patient's life circumstances and resources may facilitate physician-patient communication, increase adherence, improve health care effectiveness and efficiency and improve the patient's health and well-being," says lead study author Carmen R. Green, M.D., a pain medicine expert at the U-M Health System.

The study included 3,730 adults, all under age 50, and was designed to examine the association between race and neighborhood socioeconomic status in young black and white adults with chronic pain.

Living in a lower socioeconomic neighborhood was associated with increased sensory, affective and other pain, pain-related disability and mood disorders such as depression and anxiety, according to the study.

But blacks, especially young adults, had significantly more pain and disability whether in lower or higher socioeconomic neighborhoods, the study showed.

"Our results provide support for race as well as neighborhood socioeconomic status influencing the pain experience but further suggests that better socioeconomic status is not protective for young blacks in the same way it is for young whites," says Green.

Green is a professor of anesthesiology, obstetrics and gynecology, and health management and policy at the U-M Medical School and the U-M School of Public Health.

She collaborated with the University of Michigan's Tamera Hart-Johnson on the recent study that extends their body of research into access to health and pain care, and health and pain disparities due to age, race/ethnicity, gender, class and geography.

"Our findings show an unequal burden of pain in blacks and among those living in poor neighborhoods among the 116 million adults who experience chronic pain," Green says. "As the U.S. increasingly diversifies, and the prevalence of pain increases, it is critically important to examine health disparities due to pain in vulnerable populations."

Contact: Shantell M. Kirkendoll
University of Michigan Health System

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