Diverse findings from studies employing a variety of methodologies currently suggest that African American and Caucasian adults experience acute noxious stimulation differently, with the African American samples typically revealing greater sensitivity to pain stimuli. In a study comparing African Americans and Caucasians recruited from an interdisciplinary pain center, Edwards, Doleys, Fillingim, and Lowery reported that African American patients showed relatively lower levels of ischemic pain tolerance (induced via a submaximal effort tourniquet technique). Moreover, the investigative team examined the links between patients’ reactions to the acute pain induction and their scores on a set of clinical pain measures. Pain tolerance varied inversely with perceived pain severity. Insofar as comparative differences on the clinical measures were concerned, the African American patients yielded higher scores for pain-related disability and pain severity.
Pain is multi-billion-dollar public health concern and a significant cause of disability—particularly amongst older adults. Older adults with chronic health conditions such as osteoarthritis, diabetes mellitus, peripheral vascular disease, chronic respiratory disease, sickle cell disease, and cancer are most likely to have pain. Of particular concern are Black older adults, or Americans over the age of 65 who are the descendants of US slaves primarily from Africa, as they experience great disparities in pain management and secondary health declines. Though ample research has been completed over the past ten years that links chronic pain to psychological distress and reductions in overall physical health, adequate pain control remains problematic for Black older adults. This concern sheds light on the importance of nursing engagement and persistence in effective pain management for this population. As first line health providers, nurses are in a unique position to push forward national standards for culturally appropriate services for Black elders by ensuring that quality care is not only effective, equitable, understandable, and respectful, but also that this care is responsive to the diverse cultural health beliefs, practices, and health literacy levels of the patients they care for.
