Strogatz33 Strogatz DS. Use of medical care for chest pain: differences between blacks and whites. Am J Public Health. 1990;80(3):290-4.
|
Transversal |
Access to health services |
49% of blacks and 27% of whites have never visited a physician due to pain |
Cleeland et al.44 Cleeland CS, Gonin R, Hatfield AK, Edmonson JH, Blum RH, Stewart JA, et al. Pain and its treatment in outpatients with metastatic cancer. N Engl J Med. 1994;330(9):592-6.
|
Transversal |
Matching of pain intensity and analgesic potential |
Centers treating predominantly blacks and Hispanics had three times more chance of inadequately treating pain as compared to centers treating whites |
Vangen, Stoltenberg & Schei55 Vangen S, Stoltenberg C, Schei B. Ethnicity and use of obstetrical analgesia: do Pakistani women receive inadequate pain relief in labour? Ethn Health. 1996;1(2):161-7.
|
Transversal |
Epidural analgesia |
Pakistani females had three times more chance of not receiving analgesia as compared to Norwegian patients. |
Ng, Dimsdale, Rollnik et al.66 Ng B, Dimsdale JE, Rollnik JD, Shapiro H. The effect of ethnicity on prescriptions for patient-controlled analgesia for post-operative pain. Pain. 1996;66(1):9-12.
|
Transversal |
Morphine prescription |
Significantly higher for blacks and whites as compared to Hispanics |
Bernabei et al.77 Bernabei R, Gambassi G, Lapane K, Landi F, Gatsonis C, Dunlop R, et al. Management of pain in elderly patient with cancer. JAMA. 1998;279(23):1877-82.
|
Transversal |
Analgesics administration |
Blacks had higher chance of being undertreated as compared to whites |
Morrison et al.88 Morrison RS, Wallenstein S, Natale DK, Senzel RS, Huang L. 'We don't carry that" - failure of pharmacies in predominantily nonwhite neighborhoods to stock opioid analgesics. N Engl J Med. 2000;342(14):1023-6.
|
Transversal |
Opioids availability |
Pharmacies in non-white regions have significantly lower chance of storing opioids as compared to white regions |
Weisse et al.99 Weisse CS, Sorum PC, Sanders KN, Syat BL. Do gender and race affect decisions about pain management? J Gen Intern Med. 2001;16(4):211-7.
|
Transversal |
Analgesics prescription |
Male physicians have prescribed more to whites than to blacks and female physicians higher doses for blacks |
Choi et al.1010 Choi DM, Yate P, Coats T, Kalinda P, Paul EA. Ethnicity and prescription of analgesia in an accident and emergency department: cross sectional study. BMJ. 2000;320(7240):980-1.
|
Transversal |
Analgesics administration |
Whites received better analgesia than blacks |
Riley, Gilbert & Heft1111 Riley JL 3rd, Gilbert GH, Heft MW. Race/ethnic differences in health care use for orofacial pain among older adults. Pain. 2002;100(1-2):119-30.
|
Transversal |
Access to health services |
More white non-Hispanic and black males have visited health services as compared to black females |
Singer, Thode1212 Singer AJ, Thode HC Jr. National analgesia prescribing patterns in emergency department patients with burns. J Burn Care Rehabil. 2002;23(6):361-5.
|
Transversal |
Analgesics administration |
There has been no significant difference among races/ethnicities |
Tamayo-Sarver et al. 1313 Tamayo-Sarver JH, Dawson NV, Hinze SW, Cydulka RK, Wigton RS, Albert JM, et al. The effect of race/ethnicity and desirable social characteristics on physicians' decisions to prescribe opioid analgesics. Acad Emerg Med. 2003;10(11):1239-48.
|
Transversal |
Opioids prescription |
There has been no significant difference among races/ethnicities |
Weisse, Sorum e Dominguez1414 Weisse CS, Sorum PC, Dominguez RE. The influence of gender and race on physicians' pain management decisions. J Pain. 2003;4(9):505-10.
|
Transversal |
Opioids prescription |
Male physicians have prescribed higher doses for whites than for blacks and female physicians for blacks. |
Tamayo-Sarver et al.1515 Tamayo-Sarver JH, Hinze SW, Cydulka RK, Baker DW. Racial and ethnic disparities in emergency department analgesic prescription. Am J Public Health. 2003;93(12):2067-73.
|
Transversal |
Analgesics prescription |
There has been lower chance of being prescribed to blacks as compared to whites |
Rust et al.1616 Rust G, Nembhard WN, Nichols M, Omole F, Minor P, Barroso G, et al. Racial and ethnic disparaties in the provision of epidural analgesia to Georgia Medicaid beneficiaries during labor and delivery. Am J Obstet Gynecol. 2004;191(2):456-62.
|
Transversal |
Epidural analgesia |
Analgesia rates were lower for black, Hispanic and Asian females as compared to white and non-Hispanic females |
Gerson, Emond & Camargo1717 Gerson LW, Emond JA, Camargo CA Jr. US emergency department visits for hip fracture, 1992-2000. Eur J Emerg Med. 2004;11(6):323-8.
|
Transversal |
Analgesics administration |
There has been no significant difference among races/ethnicities |
Adams, Armstrong, Erstad1818 Adams RJ, Armstrong EP, Erstad BL. Prescribing and self-administration of morphine in Hispanic and non Hispanic Caucasian patients treated with patient-controlled analgesia. J Pain Palliat Care Pharmacother. 2004;18(2):29-38.
|
Transversal |
Morphine prescription |
There has been no significant difference among races/ethnicities |
Portenoy et al.1919 Portenoy RK, Ugarte C, Fuller I, Haas G. Population-based survey of pain in the United States: differences among white, African American, and Hispanic subjects. J Pain. 2004;5(6):317-28.
|
Transversal |
Visit to physician and analgesics prescription |
Significantly less Hispanics as compared to whites and blacks have visited the physician and blacks had higher chance as compared to whites or Hispanics of having analgesics prescribed |
Atherton, Feeg & El-Adham2020 Atherton MJ, Feeg VD, El-Adham AF. Race, ethnicity, and insurance as determinants of epidural use: anlysis of a national sample survey. Nurs Econ. 2004;22(1):6-13.
|
Transversal |
Epidural analgesia |
Hispanic females had twice more chance of not receiving analgesia as compared to non-Hispanic females |
McNeill, Sherwood & Starck2121 McNeill JA, Sherwood GD, Starck PL. The hidden errors of mismanaged pain: a systems approach. J Pain Symptoms Manage. 2004;28(1):47-58.
|
Transversal |
Pain intensity, patients' satisfaction |
Non-whites had significantly more severe pain and lower satisfaction scores with pain management as compared to whites |
Vallerand et al.2222 Vallerand AH, Hasenau S, Templin T, Collins-Bohler D. Disparaties between black and white patients with cancer pain: the effect of perception of control over pain. Pain Med. 2005;6(3):242-50.
|
Transversal |
Pain intensity, functional status |
Blacks have reported more severe pain and worse functional and mood status as compared to whites |
Taylor et al.2323 Taylor BA, Casas-Ganem J, Vaccaro AR, Hilibrand AS, Hanscom BS, Albert TJ. Differences in the work-up and treatment of conditions associated with low back pain by patient gender and ethnic background. Spine. 2005;30(3):359-64.
|
Transversal |
Access to services and therapy |
More imaging tests were recommended for whites. Whites and Asians had higher chance of having surgical indication as compared to blacks and Hispanics |
Nguyen et al.2424 Nguyen M, Ugarte C, Fuller I, Haas G, Portenoy RK. Access to care for chronic pain: racial and ethnic differences. J Pain. 2005;6(5):301-14.
|
Transversal |
Access to therapy |
Hispanics had significant less chance of visiting a pain service as compared to whites and blacks |
Green et al.2525 Green CR, Ndao-Brumblay SK, West B, Washington T. Differences in prescription opioid analgesic availability: comparing minority and white pharmacies across Michigan. J Pain. 2005;6(10):689-99.
|
Transversal |
Availability of analgesics |
Areas with predominance of whites had higher chance of analgesics as compared to areas of ethnic minorities |
Chen et al.2626 Chen I, Kurz J, Pasanen M, Faselis C, Panda M, Sataton LJ, et al. Racial differences in opioid use for chronic nonmalignant pain. J Gen Intern Med. 2005;20(7):593-8.
|
Transversal |
Opioids prescription |
Whites had higher chance of receiving analgesics as compared to blacks |
Reyes-Gibby et al.2727 Reyes-Gibby CC, Aday LA, Todd KH, Cleeland CS, Anderson KO. Pain in aging community-dwelling adults in the United States: non-Hispanic whites, non-Hispanic blacks, and Hispanics. J Pain. 2007; 8(1):75-84.
|
Transversal |
Pain intensity |
Non-Hispanic and Hispanic blacks had higher risk of having severe pain as compared to non-Hispanic whites. |
Staton et al.2828 Staton LJ, Panda M, Chen I, Genao I, Kurz J, Pasanen M, et al. When race matters: disagreement in pain perception between patients and their physicians in primary care. J Natl Med Assoc. 2007;99(5):532-8.
|
Transversal |
Difference between physicians and patients estimate of pain |
Physicians have twice the chance of underestimating pain of blacks as compared to other races |
Pletcher et al.2929 Pletcher MJ, Kertesz SG, Kohn MA, Gonzales R. Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments. JAMA. 2008;299(1):70-8.
|
Transversal |
Opioids prescription |
Whites had higher chance of receiving opioids as compared to Hispanic blacks or Asians |
Cohen et al.3030 Cohen LA, Bonito AJ, Akin DR, Manski RJ, Macek MD, Edwards RR, et al. Toothache pain: a comparison of visits to physicians, emergency departments and dentists. J Am Dent Assoc. 2008;139(9):1205-16.
|
Transversal |
Acess to dentist |
Dental service access was more difficult for Hispanics |
Edwards3131 Edwards RR. The association of perceived discrimination with low back pain. J Behav Med. 2008;31(5):379-89.
|
Transversal |
Perception of racial discrimination |
Higher perception for blacks as compared to whites was significant |
Quazi S et al.3232 Quazi S, Eberhart M, Jacoby J, Heller M. Are racial disparities in ED analgesia improving? Evidence from a national database. Am J Emerg Med. 2008;26(4):462-4.
|
Transversal |
Analgesics administration |
There has been no difference among blacks, whites and Hispanics |
Epps, Ware e Packard3333 Epps CD, Ware LJ, Packard A. Ethnic wait time differences in analgesic administration in the emergency department. Pain Manag Nurs. 2008;9(1):26-32.
|
Transversal |
Analgesics wait time |
Hispanics have waited longer as compared to Americans |
Todd, Samaroo e Hoffman3434 Todd KH, Samaroo N, Hoffman JR. Ethnicity as a risk factor for inadequate emergency department analgesia. JAMA. 1993;269(12):1537-9.
|
Retrospective |
Analgesics administration |
Hispanics had twice more chance of not receiving analgesics as compared to hon-Hispanic whites |
Mc Donald3535 Mc Donald DD. Gender and ethnic stereotyping narcotic analgesic administration. Res Nurs Health. 1994;17(1):45-9.
|
Retrospective |
Opioids administration |
Whites have received significantly more opioids as compared to blacks and Hispanics. |
Ng B et al.3636 Ng B, Dimsdale JE, Shragg GP, Deutsch R. Ethnic differences in analgesic consumption for postoperative pain. Psychosom Med. 1996;58(2):125-9.
|
Retrospective |
Morphine prescription |
Significantly lower for blacks as compared to Hispanics and whites |
Benson et al.3737 Benson NH, Sylvain H, Nimmo MJ, Dunn KA, Goodman P, O'Brien K. Influence of demographic variables in prehospital treatment of patients with chest pain. Prehosp Emerg Care. 1997;1(1):19-22.
|
Retrospective |
Analgesics administration and other interventions |
Interventions were significantly more required for whites as compared to non-whites |
Karpman, Del Mar & Bay3838 Karpman RR, Del Mar N, Bay C. Analgesia for emergency centers' orthopaedic patients: does an ethnic bias exist? Clin Orthop Relat Res. 1997;334:270-5.
|
Retrospective |
Analgesics prescription |
There has been no significant difference between whites and Hispanics |
Todd et al.3636 Ng B, Dimsdale JE, Shragg GP, Deutsch R. Ethnic differences in analgesic consumption for postoperative pain. Psychosom Med. 1996;58(2):125-9.
|
Retrospective |
Analgesics administration |
Blacks had lower chance of receiving analgesics as compared to whites |
Fuentes, Kohn & Neighbor4040 Fuentes EF, Kohn MA, Neighbor ML. Lack of association between patient ethnicity or race and fracture analgesia. Acad Emerg Med. 2002;9(9):910-5.
|
Retrospective |
Analgesics prescription |
There has been no significant difference between races/ethnicities |
Heins et al.4141 Heins JK, Heins A, Grammas M, Costello M, Huang K, Mishra S. Disparaties in analgesia and opioid prescribing practices for patients with musculoskeletal pain in the emergency department. J Emerg Nurs. 2006;32(3):219-24.
|
Retrospective |
Dose of prescribed opioids |
Significantly lower for blacks as compared to whites |
Glance et al.4242 Glance LG, Wissler R, Glantz C, Osler TM, Mukamel DB, Dick AW. Racial differences in the use of epidural analgesia for labor. Anesthesiology. 2007;106(1):19-28.
|
Retrospective |
Epidural analgesia |
Hispanic and black females had higher chance of not receiving analgesia as compared to non-Hispanic white females |
Bijur et al.4343 Bijur P, Bérard A, Esses D, Calderon Y, Gallagher EJ. Race, ethnicity, and management of pain from long-bone fractures: a prospective study of two academic urban emergency departments. Acad Emerg Med. 2008;15(7):589-97.
|
Retrospective |
Analgesics administration |
There has been no difference between races/ethnicities |
Ranasinghe et al.4444 Ranasinghe I, Chew D, Aroney C, Covadarle S, Allen R, Walters D, et al. Differences in treatment and management of indigenous and non-indigenous patients presenting with chest pain: results of the Heart Protection Partnership (HPP) study. Heart Lung Circ. 2009;17(1):32-7.
|
Retrospective |
Health Insurance, use of interventionist units |
There has been no difference between indigenous and non-indigenous |
Todd, Lee & Hoffman4545 Todd KH, Lee T, Hoffman JR. The effect of ethnicity on physician estimates of pain severity in patients with isolated extremity trauma. JAMA. 1994;271(12):925-8.
|
Prospective |
Difference between physicians' pain estimate and patients' reports |
There has been no significant difference between races/ethnicities |
Bartfield4646 Bartfield JM, Salluzzo RF, Robak-Raccio N, Verdile VP. Physician and patient factors influencing the treatment of low back pain. Pain. 1997;73(2):209-11.
|
Prospective |
Analgesics administration |
There has been no significant difference between whites and non-whites |
Cleeland et al.4747 Cleeland CS, Gonin R, Baez L, Loehrer P, Pandya KJ. Pain and treatment of pain in minority patients with cancer. Ann Intern Med. 1997;127(9):813-6.
|
Prospective |
Analgesics administration |
More blacks and Hispanics have not received adequate analgesia as compared to whites |
Carey e Garrett4848 Carey TS, Garrett JM. The relation of race to outcomes and the use of health care services for acute low back pain. Spine. 2003;28(4):390-4
|
Prospective |
Radiograph and imaging exams |
Blacks had lower chance of receiving radiographs or imaging exams as compared to whites |
Green et al.4949 Green CR, Anderson KO, Baker TA, Campbell LC, Decker S, Fillingim RB, et al. The unequal burden of pain: confronting racial and ethnic disparities in pain. Pain Med. 2003;4(3):277-94.
|
Prospective |
Management according to type of pain |
There has been no significant difference between races/ethnicities |
Rabow & Dibble5050 Rabow MW, Dibble SL. Ethnic differences in pain among outpatients with terminal and end-stage chronic illness. Pain Med. 2005;6(3):235-41.
|
Prospective |
Pain report and analgesics prescription |
Blacks have reported more severe pain as compared to whites. There has been no significant difference in opioid prescription |
Miner et al.5151 Miner J, Biros MH, Trainor A, Hubbard D, Beltram M. Patient and physician perception as risk factors for oligoanalgesia: a prospective observational study of the relief of pain in the emergency department. Acad Emerg Med. 2006;13(2):140-6.
|
Prospective observational |
Difference between physicians and patients pain estimate |
Perception of exaggerated symptoms was higher among Americans. |
Bijur et al.5252 Bijur P, Bérard A, Nestor J, Calderon Y, Davitt M, Gallagher EJ. No racial or ethnic disparity in treatment of long-bone fractures. Am J Emerg Med. 2008;26(3):270-4.
|
Prospective |
Analgesics administration |
There has been no significant difference between races/ethnicities |