title: Ethnocultural and sex characteristics of patients attending a tertiary care pain clinic in Toronto, Ontario.
abstract: BACKGROUND
  Ethnocultural factors and sex may greatly affect pain perception and expression. Emerging literature is also documenting racial and ethnic differences in pain access and care.
  
  
  OBJECTIVE
  To define the sex and ethnocultural characteristics of patients attending a tertiary care, university-affiliated pain clinic in Toronto, Ontario.
  
  
  METHODS
  Data were collected on 1242 consecutive, new patients seen over a three-year period at the Comprehensive Pain Program (CPP) in downtown Toronto. Data were compared with the Canada 2001 Census.
  
  
  RESULTS
  English-speaking, Canadian-born patients constituted 58.6% of the CPP population, similar to the 2001 Canadian Census data for the Greater Toronto Area. Certain visible minority groups (Indo-Pakistani and Chinese) were significantly under-represented, while European groups were over-represented. While women outnumbered men, they presented with lower levels of physical pathology in general, particularly in certain ethnic groups. Patients from Europe (representing primarily immigrants who arrived in Canada before 1960), were older, by 10 years to 15 years, than the average CPP population, and had a much higher incidence of physical or medical disorders.
  
  
  CONCLUSIONS
  The implications of the study and the importance of sex and ethnicity in terms of presentation to Canadian pain clinics are discussed. Future well-designed studies are needed to shed light on the role of both patients' and physicians' ethnicity and sex in pain perception and expression, decision-making regarding pain treatments and acceptance of pain treatments.
authors.affiliation: Comprehensive Pain Program, Toronto Western Hospital, Toronto, Canada. angela.mailis@uhn
authors.forename: A
authors.initials: A
authors.lastname: Mailis-Gagnon
authors.forename: B
authors.initials: B
authors.lastname: Yegneswaran
authors.forename: K
authors.initials: K
authors.lastname: Nicholson
authors.forename: S F
authors.initials: SF
authors.lastname: Lakha
authors.forename: M
authors.initials: M
authors.lastname: Papagapiou
authors.forename: A J
authors.initials: AJ
authors.lastname: Steiman
authors.forename: D
authors.initials: D
authors.lastname: Ng
authors.forename: T
authors.initials: T
authors.lastname: Cohodarevic
authors.forename: M
authors.initials: M
authors.lastname: Umana
authors.forename: M
authors.initials: M
authors.lastname: Zurowski
mesh_terms: D000367:Age Factors; D000368:Aged; D019352:Censuses; D003431:Cross-Cultural Comparison; D003710:Demography; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology*; D018710:Pain Clinics / Q000706:statistics & numerical data*; D012727:Sex Characteristics