The Intersectionality of Chronic Pain Stigma and Racial Discrimination in Black and White Adults with Chronic Low Back Pain.

Abstract

We examined the intersection between chronic pain stigma and racial discrimination, separately among Black and White U.S. adults with chronic low back pain. Participants completed measures of chronic pain stigma, lifetime experiences of racial discrimination, pain severity and interference. A composite variable representing the intersectionality of stigma and discrimination was created, and Black and White participants were separately categorized into 4 groups. Black participants were categorized as: 1) high discrimination/high stigma, 2) high discrimination/low stigma, 3) low discrimination/high stigma, and 4) low discrimination/low stigma. White participants were categorized as: 1) any discrimination/high stigma, 2) any discrimination/low stigma, 3) no discrimination/high stigma, and 4) no discrimination/low stigma. Black participants reported more frequent experiences of racial discrimination than White participants (p<.05), but there was not a racial difference in chronic pain stigma (p>.05). Among Black participants, those in the high discrimination/high stigma and low discrimination/high stigma groups reported greater pain severity and interference than those in the high discrimination/low stigma and low discrimination/low stigma groups (p<.05). Among White participants, those in the any discrimination/high stigma group reported greater pain severity and interference than those in the no discrimination/low stigma group (p<.05), but there were no differences in pain severity or interference between the any discrimination/no stigma and no discrimination/high stigma groups (p>.05). Our findings suggest that the relationship of intersectional chronic pain stigma and racial discrimination with pain is nuanced and differs across racial groups.