title: Race, ethnicity, and pain among the U.S. adult population.
abstract: BACKGROUND
  There is reliable evidence that racial/ethnic minorities suffer disproportionately from unrelieved pain compared with Whites. Several factors may contribute to disparities in pain management. Understanding how these factors influence effective pain management among racial/ethnic minority populations would be helpful for developing tailored interventions designed to eliminate racial/ethnic disparities in pain management. We conducted a review of the literature to explore the interaction between race/ethnicity, cultural influences; pain perception, assessment, and communication; provider and patient characteristics; and health system factors and how they might contribute to racial/ethnic disparities in receipt of effective pain management.
  
  
  METHODS
  The published literature from 1990-2008 was searched for articles with data on racial/ethnic patterns of pain management as well as racially, ethnically, and culturally-specific attitudes toward pain, pain assessment, and communication; provider prescribing patterns; community access to pain medications; and pain coping strategies among U.S. adults.
  
  
  RESULTS
  The literature suggests that racial/ethnic disparities in pain management may operate through limited access to health care and appropriate analgesics; patient access to or utilization of pain specialists; miscommunication and/or misperceptions about the presence and/or severity of pain; patient attitudes, beliefs, and behaviors that influence the acceptance of appropriate analgesics and analgesic doses; and provider attitudes, knowledge and beliefs about patient pain.
authors.affiliation: Division of Cancer Control and Population Sciences, Applied Research Program, National Cancer Institute (NCI), Bethesda, MD 20892-7344, USA. shaversv@mail.nih.gov
authors.forename: Vickie L
authors.initials: VL
authors.lastname: Shavers
authors.forename: Alexis
authors.initials: A
authors.lastname: Bakos
authors.forename: Vanessa B
authors.initials: VB
authors.lastname: Sheppard
mesh_terms: D000328:Adult; D005006:Ethnicity / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006801:Humans; D010146:Pain / Q000208:ethnology*; D059408:Pain Management; D010817:Physician-Patient Relations; D012307:Risk Factors; D014481:United States