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RIGHTS

For global government bodies, medical societies, and human rights organizations that consider pain management a human right, see:

• Access to Pain Management as a Human Right (2019)

• Access to Pain Management—Still Very Much a Human Right (2016)

• In the US, equal access to pain healthcare is covered as a civil rights issues by the Americans with Disabilities Act and other anti-discrimination laws.

DISPARITIES

Disparities around Race.

• Clinicians incorrectly believe that Black people feel less pain than White people, resulting in systematic under treatment (2016)

• 20 years of studies show that Black and Hispanic patients are less likely to receive pain medication for acute pain in the ER (2019)

• Implicit racial biases among pediatricians has resulted in black teens receiving less pain medication after surgery (2012)

• Brain imaging studies find that Black patients may actually experience more pain (2020)

• 4 Million Americans have chronic pain due in part to discrimination (2018)

• Inequities in healthcare disproportionately affect people of color (2019)

• Black patients report higher average levels of pain but, in 90% of US healthcare systems, receive significantly lower doses of pain medication (2021)

• For recent examples of NPAC members featured in stories about racial disparities in research and care for pain, see Truth Out and STATnews.

Disparities around Sex & Gender.

On women’s pain:

• Women experience greater pain, have more diseases causing pain, and have their pain dismissed by clinicians (various articles)

• Different biological pathways may be responsible for pain in males (glial cells) and females (t cells) (2020) & Nature (2019)

• A meta-analysis reveals gender bias in pain treatment and heightened barriers to care (2018)

• For more information on the healthcare system’s failure of women, see Dusenbery’s “Doing Harm” (2018)

On transgender pain:

• Gender identity also plays a role in severity of pain experienced (2020)

• Significant health disparities affect people who are transgender (2018)

Disparities around Disability. 

• Pain is the chief cause of disability worldwide, according to the global burden of disease studies (2016), and in the US according to the Institute for Health Metrics and Evaluation (IHME) (2016)

• People with disabilities have often comorbid conditions causing pain and face barriers in care so they struggle to get appropriate pain treatment:

• People with disabilities face physical and communication barriers that limit their access to pain treatment (various, CDC).

• People with intellectual or developmental disabilities face barriers being believed or understood that have implications for the management of their pain (2014)

• People with disabilities face barriers related to misperceptions and biases of providers (NAESM, various)

Disparities around Service Members & Veterans.

• Veterans who experience chronic pain are about 40% more likely to have severe pain than the average person, according to the VA’s Health Services and Research Development (various)

• Veterans have greater severity of pain overall compared with the general population (2017)

• Pain is one of the chief health complaints of Veterans (2015)

Disparities around Age.

On Children:

• Pain prevention and treatment in children is inadequate (2020)

• Pain is rising among younger Americans as compared with the previous generations (2020)

On Older People:

• Bothersome pain afflicts 18.8 Million older adults in the US (2013)

• Two thirds of older Americans suffer multiple chronic conditions; an estimated 60-75% of people over 65 report chronic pain (2014)

• Americans are experiencing increasing pain in middle age (2020)