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The following is a summary of “Mechanisms of the Native American pain inequity: predicting chronic pain onset prospectively at 5 years in the Oklahoma Study of Native American Pain Risk,” published in the November 2024 issue of Pain by Rhudy et al. 

Researchers conducted a retrospective study to examine the mechanisms in Native Americans (NAs) of pain inequity by assessing biopsychosocial factors.  

They recruited healthy NAs and non-Hispanic White (NHWs), pain-free individuals who attended 2 laboratory visits for assessments related to the biopsychosocial model of pain. Surveys were administered every 6 months to track chronic pain onset. Data analysis at the 2-year follow-up compared chronic pain development between the 2 groups. The study extended to a 5-year follow-up to examine the worsening of pain inequity.  

The results showed that at the 2-year follow-up, NAs were 3 times more likely to develop chronic pain than NHWs, the psychosocial factors (discrimination, stress, pain-related anxiety), cardiometabolic load (higher BMI, blood pressure, lower heart rate variability), and impaired spinal nociception inhibition partially mediated the inequity. By the 5-year follow-up, the NAs developed 4 times more chronic pain with worsening of pain inequity, even after controlling for demographics and socioeconomic factors. Serial mediation models replicated previous findings and identified 2 new significant paths: 1 linking psychosocial factors, sleep problems, and facilitated pain perception to increased pain risk, and another linking discrimination to higher spinal nociceptive threshold and pain risk.  

Investigators concluded the evidence in NAs for pain inequity and identified multiple psychosocial, cardiometabolic, and pronociceptive targets for primary interventions. 

Source: journals.lww.com/pain/abstract/9900/mechanisms_of_the_native_american_pain_inequity_.765.aspx