Grol-Prokopczyk Hanna, Huang Rui, Yu Chang, Chen Yu-An, Kaur Sirat, Limani Merita, Lin Ting-Hui, Zajacova Anna, Zimmer Zachary, Cowan Penney, Fillingim Roger B, Gewandter Jennifer S, Gilron Ian, Hirsh Adam T, Macfarlane Gary J, Meghani Salimah H, Patel Kushang V, Poleshuck Ellen L, Strain Eric C, Symons Frank J, Wesselmann Ursula, Dworkin Robert H, Turk Dennis C
University at Buffalo, State University of New York, Buffalo, NY, United States.
University of Western Ontario, London, ON, Canada.
Pain. 2025 Jun 24. doi: 10.1097/j.pain.0000000000003676.
Research on social disparities in pain and pain treatment has grown substantially in recent decades, as reflected in a growing number of review articles on these topics. This scoping review of reviews provides a macrolevel overview of scholarship in this area by examining what specific topics and findings have been presented in published reviews. We searched CINAHL, Cochrane Database of Systematic Reviews, Embase, PsycINFO, PubMed, and Web of Science for English-language, peer-reviewed review articles, qualitative or quantitative, that aimed to characterize or explain pain-related differences or inequities across social groups. Of 4432 unique records screened, 397 articles, published over a 56-year period, were included. For each, we documented (1) axes of social difference studied (eg, sex/gender, race/ethnicity), (2) pain-related outcomes (eg, chronic pain prevalence), (3) broad findings, (4) types of mechanisms proposed, and (5) policy or practice recommendations. Findings reveal a sharp increase in the number of published review articles on pain-related disparities since approximately the year 2000. The most commonly studied social dimension was sex/gender, followed by race/ethnicity and age. Studies examining disparities by socioeconomic status, geography, or other categories were rarer. While most findings showed disadvantaged social groups to have worse pain outcomes, there were intriguing exceptions. Biological, psychological, and sociocultural mechanisms were considered much more frequently than sociostructural (macrolevel) ones. Policy/practice recommendations were typically individual-level behavioral suggestions for providers or patients. We identify high-priority areas for future research, including greater attention to lower-income countries, chronic pain prevention, and macrolevel drivers of pain disparities.
近几十年来，关于疼痛及疼痛治疗方面社会差异的研究大幅增加，这体现在越来越多关于这些主题的综述文章中。本综述性文献综述通过考察已发表综述中呈现了哪些具体主题和研究结果，对该领域的学术研究进行了宏观概述。我们在护理学与健康领域数据库（CINAHL）、考克兰系统评价数据库、荷兰医学文摘数据库（Embase）、心理学文摘数据库（PsycINFO）、医学期刊数据库（PubMed）和科学引文索引数据库（Web of Science）中检索了英文、同行评审的综述文章，包括定性或定量研究，这些研究旨在描述或解释不同社会群体之间与疼痛相关的差异或不平等。在筛选的4432条独特记录中，纳入了在56年期间发表的397篇文章。对于每一篇文章，我们记录了：（1）所研究的社会差异维度（如性别、种族/民族）；（2）与疼痛相关的结果（如慢性疼痛患病率）；（3）主要研究结果；（4）所提出的机制类型；（5）政策或实践建议。研究结果显示，自2000年左右以来，关于疼痛相关差异的已发表综述文章数量急剧增加。最常研究的社会维度是性别，其次是种族/民族和年龄。考察社会经济地位、地理位置或其他类别的差异的研究较少。虽然大多数研究结果表明处于社会劣势的群体疼痛结果更差，但也有一些有趣的例外情况。生物、心理和社会文化机制比社会结构（宏观层面）机制被考虑得更为频繁。政策/实践建议通常是针对医疗服务提供者或患者个人层面的行为建议。我们确定了未来研究的高优先领域，包括更多关注低收入国家、慢性疼痛预防以及疼痛差异的宏观层面驱动因素。
