Bill M Jesdale1, Deborah S Mack2, Sarah N Forrester2, Kate L Lapane2. 1. Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA. Electronic address: William.Jesdale@umassmed.edu. 2. Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA.
Abstract
OBJECTIVES: To estimate pain reporting among residents with cancer in relation to metropolitan area segregation and NH racial and ethnic composition. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: 383,757 newly admitted black (B), Hispanic (H), or white (W) residents with cancer in 12,096 US NHs (2011-2013). METHODS: Using the Minimum Data Set 3.0, pain in past 5 days was determined by self-report or use of pain management. The Theil entropy index, a measure of metropolitan area segregation, was categorized [high (up to 0.20), very high (0.20-0.30), or extreme (0.30-0.53)]. RESULTS: Pain prevalence decreased across segregation level (black: high = 77%, very high = 75%, extreme = 72%; Hispanic: high = 79%, very high = 77%, extreme = 70%; white: high = 80%, very high = 77%, extreme = 74%). In extremely segregated areas, all residents were less likely to have recorded pain [adjusted prevalence ratios: blacks, 4.6% less likely, 95% confidence interval (CI) 3.1%-6.1%; Hispanics, 6.9% less likely, 95% CI 4.2%-9.6%; whites, 7.4% less likely, 95% CI 6.5%-8.2%] than in the least segregated areas. At all segregation levels, pain was recorded more frequently for residents (black or white) in predominantly white (>80%) NHs than in mostly black (>50%) NHs or residents (Hispanic or white) in predominantly white NHs than mostly Hispanic (>50%) NHs. CONCLUSIONS AND IMPLICATIONS: We observed decreased pain recording in metropolitan areas with greater racial and ethnic segregation. This may occur through the inequitable distribution of resources between NHs, resident-provider empathy, provider implicit bias, resident trust, and other factors.
OBJECTIVES: To estimate pain reporting among residents with cancer in relation to metropolitan area segregation and NH racial and ethnic composition. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: 383,757 newly admitted black (B), Hispanic (H), or white (W) residents with cancer in 12,096 US NHs (2011-2013). METHODS: Using the Minimum Data Set 3.0, pain in past 5 days was determined by self-report or use of pain management. The Theil entropy index, a measure of metropolitan area segregation, was categorized [high (up to 0.20), very high (0.20-0.30), or extreme (0.30-0.53)]. RESULTS:Pain prevalence decreased across segregation level (black: high = 77%, very high = 75%, extreme = 72%; Hispanic: high = 79%, very high = 77%, extreme = 70%; white: high = 80%, very high = 77%, extreme = 74%). In extremely segregated areas, all residents were less likely to have recorded pain [adjusted prevalence ratios: blacks, 4.6% less likely, 95% confidence interval (CI) 3.1%-6.1%; Hispanics, 6.9% less likely, 95% CI 4.2%-9.6%; whites, 7.4% less likely, 95% CI 6.5%-8.2%] than in the least segregated areas. At all segregation levels, pain was recorded more frequently for residents (black or white) in predominantly white (>80%) NHs than in mostly black (>50%) NHs or residents (Hispanic or white) in predominantly white NHs than mostly Hispanic (>50%) NHs. CONCLUSIONS AND IMPLICATIONS: We observed decreased pain recording in metropolitan areas with greater racial and ethnic segregation. This may occur through the inequitable distribution of resources between NHs, resident-provider empathy, provider implicit bias, resident trust, and other factors.
Authors: R Bernabei; G Gambassi; K Lapane; F Landi; C Gatsonis; R Dunlop; L Lipsitz; K Steel; V Mor Journal: JAMA Date: 1998-06-17 Impact factor: 56.272
Authors: Barbara Resnick; Kimberly Van Haitsma; Ann Kolanowski; Elizabeth Galik; Marie Boltz; Jeanette Ellis; Liza Behrens; Karen Eshraghi Journal: J Nurs Care Qual Date: 2021-11-12 Impact factor: 1.728
Authors: Barbara Resnick; Kimberly Van Haitsma; Ann Kolanowski; Elizabeth Galik; Marie Boltz; Jeanette Ellis; Liza Behrens; Karen Eshraghi; Cynthia L Renn; Susan G Dorsey Journal: Front Pain Res (Lausanne) Date: 2021-12-02