Using the Socioecological Model to Explain Disparities in Pain Management Between Hispanic and White Adults: A Literature Review




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Purpose: There is a longstanding history of racial disparities in pain management in the United States. Previous research has highlighted a trend in which Black and Hispanic patients are disproportionately at risk of experiencing inadequate pain treatment. For instance, studies have established that they are less likely to be prescribed analgesia and opioids compared to their White counterparts. Despite this knowledge, the underlying factors contributing to these disparities remain largely unexplored, particularly those concerning the Hispanic adult population. The purpose of this literature review is to utilize the socioecological model to explore patient, provider, and societal factors contributing to disparities in pain management between White and Hispanic adults.

Methods: The literature review was conducted on PubMed. A combination of key terms was used to search for articles discussing disparities in pain management between Hispanic and White adults. Articles were included in the review if they were written in English, based in the United States, published in 2013 or later, and utilized one or many keywords in the title or abstract. Furthermore, only quantitative and qualitative studies, systematic reviews, and narrative reviews were considered. Using these criteria, a total of 18 articles were selected for review.

Results: The results of this literature review support the notion that socio-ecological factors interact with one another and collectively contribute to disparities in pain management. At the patient level, differences in coping styles, underreporting pain, and perceived racial discrimination influence Hispanic patients' decision to seek pain management care from healthcare providers. At the provider level, bias and discrimination against Hispanic patients regarding pain treatment, along with language barriers, contribute to unequal healthcare practices. Finally, at the societal level, social and economic barriers impact Hispanic patients' ability to access and afford pain management care.

Conclusion: This literature review aimed to identify patient, provider, and societal level factors that contribute to disparities in pain care between Hispanic and White adults in the US. Understanding the unique challenges the Hispanic adult population face is crucial for developing targeted interventions and improving equitable access to pain management services. Therefore, healthcare providers should strive to identify and mitigate as many of these factors as possible to alleviate disparities in pain management and deliver equitable care.