Disparities in Pain Care Treatment In The Socioeconomic World | The Doctor Weighs In

The Doctor Weighs In
11 min readJun 10, 2021

By Allen W. Burton, M.D.

Digital and telehealth are potential solutions for many, helping bridge the divide for those who have few options because of socioeconomic factors.

Pain

Conceptually, over our lifetime we all gain some understanding and insights into pain. But for a person living with pain, it can seem as if the world doesn’t understand.

And the truth is, sometimes the world doesn’t understand.

Even for medical professionals, whose primary role is to provide care, chronic pain can be difficult to appreciate. Because chronic pain is measured subjectively and not well understood, physicians historically viewed chronic pain as a characterological flaw rather than a “true” disease. While we have come a long way in understanding chronic pain states from a pathophysiologic basis, we still have a long way to go. A person’s socioeconomic status, race, ethnicity, and gender may disproportionally expose them to this historical bias in viewing their pain as more “psychosomatic” or less legitimate, thereby subjecting them to disparities in receiving appropriate pain care.

We know, for example, that racial and ethnic minorities are less likely to receive adequate treatment for both acute and chronic pain than their white counterparts, even after controlling for variables, such as age, gender, and intensity of pain.[1] And when looking at gender, we find that women’s pain is more likely to be downplayed by healthcare-even in the literature-because there is a perception that women are more sensitive to pain or that they are more likely to report pain when compared to men.[2]

When pain isn’t taken seriously, then people don’t get the care they need to address it. Nowhere is this more evident than in interventional pain care, where therapies, such as spinal cord stimulation, dorsal root ganglion and radiofrequency ablation, are underutilized relative to how long these types of therapies have been available and the number of patients who could benefit from them. But simply trying to increase the number or access to interventional procedures isn’t the answer. Instead, we need to understand the barriers that exist and address them…

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