Chronic Pain After Trauma Greater in Black and Hispanic vs White Patients

Authors of letter to the editor published in Pain Medicine reported that Black and Hispanic survivors of traumatic injury describe greater pain severity at 12 months than their White counterparts.

A team of investigators sourced data for this analysis from the Consequences of Traumatic Injury (COTI) study, which was a prospective study conducted between 2017 and 2020 at Baylor University Medical Center and the University of Pennsylvania trauma centers. Adults aged 18 to 65 years who suffered an acute physical injury were oversampled for Hispanic and Black race/ethnicity. At 3 and 12 months, participants (N=650; 247 Black, 218 White, 166 Hispanic, and 19 other race/ethnicity) were interviewed about pain outcomes.

The mean age of study participants was 40.0 (standard deviation [SD], 14.2) years, 68.0% were men, mean Injury Severity Score was 10.0 (SD, 7.7) points, mean pain severity score was 6.3 (SD, 2.1) points, and mean duration of hospitalization was 6.6 (SD, 6.1) days. Sources of injury included motor vehicle accident (42.0%), fall or other mechanism (34.2%), and interpersonal violence (25.5%). 

At 3 months, the cohort described as other ethnicity reported the highest pain (mean, 4.0 points), followed by Black (mean, 3.9 points), Hispanic (mean, 2.5 points), and White (mean, 2.4) groups. At 12 months, Black patients reported the highest pain (mean, 3.8 points), followed by other ethnicity (mean, 3.6 points), Hispanic (mean, 2.7 points), and White (mean, 2.2 points) patients.

In the fully adjusted model, which included pain predisposition and injury mechanics, pain severity was associated with Black ethnicity (β, 0.80; P =.003) at 3 months compared with White. Pain severity at 12 months was significantly associated with both Black (β, 0.63; P =.03) and Hispanic (β, 0.61; P =.04) ethnicities compared with White.

Study authors conclude that significant racial and ethnic disparities exist for pain intensity following traumatic injury, with Black and Hispanic patients reporting greater persistence of pain than White patients. These differences were not fully explained by predisposition to pain or injury mechanisms. The study authors conclude, “Additional research is needed to identify interventions that can mitigate these disparities, specifically those that address clinical, socioeconomic, or cultural factors that impede recovery from trauma or that facilitate the development of chronic pain.”