Race, care seeking, and utilization for chronic back and neck pain: population perspectives.
We analyzed a statewide survey of individuals with chronic back and neck pain to determine whether prevalence and care use varied by patient race or ethnicity. We conducted a telephone survey of a random sample of 5,357 North Carolina households in 2006. Adults with chronic (>3 months duration or >24 episodes of pain per year), impairing back or neck pain were identified and were asked to complete a survey about their health and care utilization. 837 respondents (620 white, 183 black, 34 Latino) reported chronic back or neck pain. Whites and blacks had similar rates of chronic back pain. Back pain prevalence was lower in Latinos (10.4% [9.3-11.6] vs 6.3% [3.8-8.8]), likely due to their younger age; and the prevalence of chronic, disabling neck pain was lower in blacks (2.5% [1.9-3.1] vs 1.1% [.04-1.9]). Blacks had higher pain scores in the previous 3 months (5.2 vs 5.9 P < .05), and higher Roland disability scores (0-23 point scale): 14.2 vs 16.8, P < .05. Care seeking was similar among races (83% white, 85% black, 72% Latino). Use of opioids was also similar between races, at 49% for whites, 52% for blacks, and trended lower at 35% for Latinos. We found few racial/ethnic differences in care seeking, treatment use, and use of narcotics for the treatment of chronic back and neck pain.


CONCLUSIONS
This article presents new, population-based data on the issue of racial and ethnic disparities in neck- and back-pain prevalence and care. Few disparities were found; care quality issues may affect all ethnic groups similarly. Previous findings of disparities in chronic-pain management may be decreasing, or may perhaps be site specific.
Department of Medicine, UNC Chapel Hill, North Carolina; Cecil G Sheps Center for Health Services Research, UNC Chapel Hill, North Carolina, USA. Tim_Carey@unc.edu
Timothy S
TS
Carey
Janet K
JK
Freburger
G Mark
GM
Holmes
Anne
A
Jackman
Stefanie
S
Knauer
Andrea
A
Wallace
Jane
J
Darter
D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D017677:Age Distribution; D000701:Analgesics, Opioid / Q000627:therapeutic use; D001416:Back Pain / Q000453:epidemiology* / Q000628:therapy; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D003625:Data Collection; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006304:Health Status; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology* / Q000628:therapy; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011159:Population Surveillance; D015995:Prevalence; D044469:Racial Groups / Q000523:psychology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data
D000701:Analgesics, Opioid