(232) Assessing Chronic Pain Onset in Native Americans: Follow-Up Results from the Oklahoma Study of Native American Pain Risk (OK-SNAP)

Abstract

Chronic pain leads to considerable suffering and disability. Epidemiological evidence suggests that Native Americans (NA) suffer from chronic pain at higher rates than any other U.S. racial/ethnic group. However, to our knowledge, no study has examined this issue prospectively to examine whether healthy, pain-free NAs are more likely to develop chronic pain after controlling for other health variables. For the present study, healthy, pain-free participants were enrolled in a study (OK-SNAP) that assessed a variety of variables associated with pain processing and pain risk. Enrollment began in March 2014. Following enrollment, follow-up surveys were administered every 6-months to assess whether chronic pain developed. Of the 139 NA and 147 non-Hispanic white (NHW) participants enrolled, 208 (73%) responded to at least 1 follow-up. Participants were deemed to have chronic pain if they experienced persistent pain for >3 months that did not remit at subsequent follow-ups (N=34; 16%). On average these individuals reported several locations with persistent pain (M=3.71, SD=3.64), including lower (56%) and upper (35%) back, neck (29%), shoulder (29%), feet (29%), knees (26%), legs (21%), and hips (21%). This chronic pain group was compared to those that did not develop chronic pain (N=174). A logistic regression was conducted with race (NHW vs. NA) as a predictor, after controlling for age, BMI, income, and sex. Race emerged as the only significant predictor (OR=3.015, 95% CI: 1.309, 6.945) indicating that NAs were 3x more likely to develop chronic pain than NHWs, an effect that explained 10.4% of the variance in pain onset (Nagelkerke R2=.104). These prospective findings are consistent with prior epidemiological reports that there is a pain disparity within the NA community. Future studies are needed to examine the mechanisms for this disparity.