Race and ethnicity do not affect baseline self-report of pain severity in patients with suspected long-bone fractures.
ABSTRACT To determine whether race or ethnicity affect baseline description of pain by patients with suspected long-bone fracture.
Secondary analysis of data from an observational study of patients age 18-55 in two urban emergency departments.
Patients rated their pain using an 11-point scale, where 0 represents no pain, and 10 represents the worst possible pain.
Of 838 patients, 49% were Hispanic, 29% African American, and 22% White. Mean baseline pain scores were, respectively, 8.2, 8.1, and 7.7. In multivariate analysis, pair-wise comparisons showed no significant differences in pain self-report.
Ethnoracial oligoanalgesia cannot be explained by differences in baseline pain severity.
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ABSTRACT: Twenty years is a long time in the life of a preventable epidemic. In 1990 when HIV was infecting and AIDS was killing white gay and bisexual men and threatening the general public, there was public concern about the disease and federal research and prevention dollars flowed. It was well established that HIV was spread primarily through sexual intercourse without barrier protection such as condoms. “Risky sex” occurred between men and between men and women. By 2000, HIV infection rates and deaths due to AIDS were in decline among White men in AIDS epi-centers, but continued among African Americans. The HIV/AIDS epidemic has not only continued its course among Blacks but also concentrated among black men and in black communities and has become yet another affliction among Blacks. At the very same time, public attention and urgency to the AIDS epidemic has waned and prevention dollars have been largely replaced by funding of clinical trials of new drugs. If you are Black and poor, there are now, in fact, more incentives to get infected with HIV to get social support through a clinical trial then to avoid getting infected in the first place. Public and government indifference to disease among Blacks but a willingness at the same time to use them in research are precisely the same reactions to disproportionate rates of yellow fever, typhus, syphilis, and tuberculosis among Blacks during Jim Crow segregation in the early twentieth century (McBride, 1991).12/2010: pages 183-195;
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ABSTRACT: BACKGROUND: Inadequate treatment of painful conditions in children is a significant and complex problem. The objective of this study was to examine the effect of race/ethnicity on the provision of analgesic medicines at discharge in children treated emergently for a long-bone fracture. METHODS: A retrospective review of all patients during a 1-year period with a long-bone fracture treated in 2 urban pediatric emergency departments was performed. RESULTS: Eight hundred seventy-eight patients who met our inclusion criteria were identified. Sixty percent of patients received a prescription for an opioid-containing medicine, and 19% received a prescription for an over-the-counter analgesic medicine at emergency department discharge. Patients identified as African American, non-Hispanic, biracial, and Hispanic/Latino had significantly lower rates of opioid analgesic prescriptions when compared with other ethnic groups. White, non-Hispanic patients had lower rates of over-the-counter analgesic medicine prescriptions provided at discharge. Patients identified as white, non-Hispanic had a higher percentage of fractures that required reduction in the emergency department when compared with other ethnic groups. CONCLUSIONS: Race/ethnicity is associated with different analgesic prescription patterns in children treated in the emergency department for a long-bone fracture.Pediatric emergency care 03/2013; · 0.92 Impact Factor
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ABSTRACT: BACKGROUND: Treatment for pain and pain-related conditions has been identified as the most common reason for Emergency Department (ED) visits. OBJECTIVE: This study was undertaken to characterize the distribution of self-reported pain scores for common ED diagnoses. METHODS: In this retrospective exploratory chart review, eligible participants included all adult ED patients age 18 years and over, with a self-reported triage pain score of 1 or higher during January-June 2011. Data were collected from ED electronic medical records. RESULTS: Among 1229 patients, the mean age was 44 years; 56% of patients were female, and 59% were white. The mean triage pain score for all patients was 7.1 (interquartile range 6-9). The most common reported diagnoses included: minor injuries (10%), abdominal pain (8%), and respiratory infections (8%). The diagnoses with the highest mean pain scores were: sickle cell crisis (mean pain score 8.7), back/neck/shoulder pain (8.5), and headache/migraine (8.3). Higher pain scores were significantly correlated with younger age (p<0.001) and number of ED visits (p<0.001). Demographic factors including female gender, African American race, and Medicaid insurance reported significantly higher pain scores (p<0.001). Patients with multiple ED visits in the recent 12 months reported significantly higher pain scores (p<0.001). CONCLUSION: ED patients report a wide variety of pain scores. Factors associated with higher pain scores included younger age, female gender, African American race, Medicaid insurance status, multiple ED visits in the past year, and ED diagnoses of sickle cell crisis, back/neck/shoulder pain, and headache.Journal of Emergency Medicine 07/2012; · 1.18 Impact Factor