Pain Coping in Racially Diverse American Patients

Are black Americans more likely to use negative coping strategies for chronic pain?

Do black Americans experience and deal with pain differently than white Americans? The answer is yes, according to a recent meta-analysis published in the Journal of Pain.1

Chronic pain affects about 100 million Americans, but the pain experience differs among individuals and between people of different racial backgrounds. Numerous studies have shown that black Americans report higher levels of pain and lower pain tolerance, but this meta-analytic review is the first to quantify the relationship between race and the use of pain coping strategies.

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Coping strategies include certain behaviors or cognitive techniques used to manage the stress of pain.

The three most common categories are cognitive versus behavioral, active versus passive, and problem-focused versus emotion-focused. Studies show that black Americans are more likely to rely on passive, emotion-focused, and cognitive strategies.1

Black Americans More Likely to Pray, Catastrophize

The meta-analysis included 19 American studies with 6489 participants. Results showed that black Americans used pain coping strategies more frequently than white Americans (P < .01).

The biggest disparity was in the use of hoping and praying (P < .001), and catastrophizing (P < .001), coping mechanisms that are generally associated with poorer outcomes.

According to the authors, the findings may help explain why black Americans experience pain more negatively than white Americans.

“We found that race differences were largest for passive versus active coping strategies and for emotion-focused versus problem-focused strategies,” author Adam T. Hirsh, PhD, assistant professor of psychology from Indiana University-Purdue University in Indianapolis, told Clinical Pain Advisor.

Among prior research cited in the review is a study by Robert Randolph Edwards, PhD, from the department of anesthesia and pain management at Harvard Medical School and Brigham and Women’s Hospital in Boston, and colleagues.