title: A quantitative review of ethnic group differences in experimental pain response: do biology, psychology, and culture matter?
abstract: OBJECTIVE
  Pain is a subjectively complex and universal experience. We examine research investigating ethnic group differences in experimental pain response and factors contributing to group differences.
  
  
  METHODS
  We conducted a systematic literature review and analysis of studies using experimental pain stimuli to assess pain sensitivity across multiple ethnic groups. Our search covered the period from 1944 to 2011, and used the PubMed bibliographic database; a reference source containing over 17 million citations. We calculated effect sizes; identified ethnic/racial group categories, pain stimuli, and measures; and examined findings regarding biopsychosociocultural factors contributing to ethnic/racial group differences.
  
  
  RESULTS
  We found 472 studies investigating ethnic group differences and pain. Twenty-six of these met our review inclusion criteria of investigating ethnic group differences in experimental pain. The majority of studies included comparisons between African Americans (AA) and non-Hispanic Whites (NHW). There were consistently moderate to large effect sizes for pain tolerance across multiple stimulus modalities; AA demonstrated lower pain tolerance. For pain threshold, findings were generally in the same direction, but effect sizes were small to moderate across ethnic groups. Limited data were available for suprathreshold pain ratings. A subset of studies comparing NHW and other ethnic groups showed a variable range of effect sizes for pain threshold and tolerance.
  
  
  CONCLUSIONS
  There are potentially important ethnic/racial group differences in experimental pain perception. Elucidating ethnic group differences has translational merit for culturally competent clinical care and for addressing and reducing pain treatment disparities among ethnically/racially diverse groups.
authors.affiliation: Department of Behavioral Science and Community Health, University of Florida, College of Public Health and Health Professions, Gainesville, Florida 32610, USA. brwms@phhp.ufl.edu
authors.forename: Bridgett
authors.initials: B
authors.lastname: Rahim-Williams
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Riley
authors.forename: Ameenah K K
authors.initials: AK
authors.lastname: Williams
authors.forename: Roger B
authors.initials: RB
authors.lastname: Fillingim
mesh_terms: D001741:Black or African American / Q000208:ethnology / Q000523:psychology; D003469:Culture; D005006:Ethnicity / Q000523:psychology*; D006630:Hispanic or Latino / Q000208:ethnology / Q000523:psychology; D006801:Humans; D010146:Pain / Q000208:ethnology* / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods; D058748:Pain Perception / Q000502:physiology; D017288:Pain Threshold / Q000208:ethnology* / Q000523:psychology*; D044465:White People / Q000208:ethnology / Q000523:psychology