Intrarace Differences Among Black and White Americans Presenting for Chronic Pain Management: The Influence of Age, Physical Health, and Psychosocial Factors


Reprint requests to: Carmen R. Green, MD, Associate Professor, University of Michigan Medical Center, Department of Anesthesiology, 1500 East Medical Center Drive, 1H247 UH – Box 0048, Ann Arbor, MI 48109-0048, USA. Tel: (734) 936-4280; Fax: (734) 936-9091; E-mail:


Objective.  Emerging comparative literature documents significant racial differences in the chronic pain experience in terms of physical, psychological, and social well-being. However, the intrarace differences of chronic pain among black Americans and white Americans has not been extensively investigated. The purpose of this investigation was to examine the potential within-race-group differential effects and the psychosocial aspects of chronic pain in black and white Americans across age groups.

Design.  A retrospective study of patients presenting for chronic pain management.

Setting.  A tertiary care multidisciplinary pain center.

Patients.  Patients were younger (<50 years) (mean ± SD: 36.7 ± 8.4) and older (≥50 years) (60 ± 9.3) black Americans (N = 525), and younger (36.6 ± 8.1) and older (63 ± 9.8) white Americans (N = 5,298).

Outcome Measures.  Participants were measured on depressive symptoms, social functioning, pain intensity, pain-related disability, and physical comorbidities.

Results.  Younger black Americans reported more depressive symptoms, pain intensity, and were less successful at coping with pain when compared to older black Americans. Similar within-group differences were also observed for reports of depressive symptoms, pain intensity, and coping abilities among white Americans. Results further showed that younger white Americans also experienced more symptoms related to post-traumatic distress than older white Americans.

Conclusion.  Examining within-race-group variability suggests that chronic pain differentially affects the quality of life and health status of black Americans and white Americans across age groups. This study emphasizes the need for further chronic pain studies examining pain indicators within defined racial and ethnic groups.