Racial and ethnic disparities in pain management in the United States.
OBJECTIVE
To critically examine research on racial and ethnic disparities in pain management with a focus on who has been studied, the magnitude of disparities, and potential explanations for those disparities.


METHODS
A systematic literature review. Articles included were reports of original research in which at least two racial or ethnic groups were compared on adequacy of pain management.


METHODS
Review of research articles published between 1990 and 2004 with the primary aim of identifying the influence of race or ethnicity on pain management in the US. Databases were CINAHL, Medline, and Pubmed. Relevant articles were categorized by pain type. Effect sizes were calculated where sufficient data were provided.


RESULTS
Studies were focused on Blacks or African Americans, Whites or non-Hispanic Whites, Hispanics, and Asians. Terms for describing these groups were neither well defined nor consistently used within and across studies. Disparities in pain management were reported in relation to minority status, but the magnitudes of these disparities were mostly small.


CONCLUSIONS
Greater clarity and consistency are needed in the use of the terms race, ethnicity, and minority. Groups were treated as if they were homogeneous, and details were lacking about whether subgroups of different races or ethnicities had been studied. Although reported disparities in pain management were small, they were consistent. Further research is needed to examine differences within groups and to explain possible reasons for disparities across groups.
Ezenwa
Miriam O
MO
University of Wisconsin-Madison School of Nursing, Clinical Science Center, Madison, WI 53792, USA. moezenwa@wisc.edu
Ameringer
Suzanne
S
Ward
Sandra E
SE
Serlin
Ronald C
RC
D001741:Black or African American / Q000208:ethnology*; D001213:Asian / Q000208:ethnology*; D001294:Attitude to Health / Q000208:ethnology; D015987:Effect Modifier, Epidemiologic; D005544:Forecasting; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006304:Health Status; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D008913:Minority Groups; D015399:Nursing Research / Q000458:organization & administration; D010146:Pain / Q000175:diagnosis / Q000208:ethnology; D059408:Pain Management; D010147:Pain Measurement / Q000523:psychology / Q000592:standards; D011287:Prejudice; D011787:Quality of Health Care / Q000458:organization & administration*; D012107:Research Design; D012959:Socioeconomic Factors; D013240:Stereotyping; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People / Q000208:ethnology*