Campbell Claudia M, Edwards Robert R
Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, G Building, Suite 100, Baltimore, MD 21224, USA.
Pain Manag. 2012 May;2(3):219-230. doi: 10.2217/pmt.12.7.
Considerable evidence demonstrates substantial ethnic disparities in the prevalence, treatment, progression and outcomes of pain-related conditions. Elucidating the mechanisms underlying these group differences is of crucial importance in reducing and eliminating disparities in the pain experience. Over recent years, accumulating evidence has identified a variety of processes, from neurophysiological factors to structural elements of the healthcare system, that may contribute to shaping individual differences in pain. For example, the experience of pain differentially activates stress-related physiological responses across various ethnic groups, members of different ethnic groups appear to use differing coping strategies in managing pain complaints, providers' treatment decisions vary as a function of patient ethnicity and pharmacies in predominantly minority neighborhoods are far less likely to stock potent analgesics. These diverse factors, and others may all play a role in facilitating elevated levels of pain-related suffering among individuals from ethnic minority backgrounds. Here, we present a brief, nonexhaustive review of the recent literature and potential physiological and sociocultural mechanisms underlying these ethnic group disparities in pain outcomes.
大量证据表明,在与疼痛相关疾病的患病率、治疗、进展和结局方面存在显著的种族差异。阐明这些群体差异背后的机制对于减少和消除疼痛体验方面的差异至关重要。近年来,越来越多的证据表明,从神经生理因素到医疗保健系统的结构要素等各种过程,可能有助于塑造个体在疼痛方面的差异。例如,疼痛体验在不同种族群体中差异性地激活与压力相关的生理反应,不同种族的成员在处理疼痛主诉时似乎使用不同的应对策略,医疗服务提供者的治疗决策因患者种族而异,而在主要为少数族裔社区的药店中,储备强效镇痛药的可能性要小得多。这些不同的因素以及其他因素都可能在促使少数族裔背景个体的疼痛相关痛苦水平升高方面发挥作用。在此,我们对近期文献以及这些种族群体在疼痛结局方面差异背后潜在的生理和社会文化机制进行简要的、非详尽的综述。