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One of the most challenging treatment dilemmas facing a practicing pediatrician is the management of a child with chronic pain, because it is well established that pain is a highly complex phenomenon that involves biological, psychological, and social variables such as culture, race, and ethnicity.1,2 Understanding the role of culture in the experience of pain is of particular importance when one considers that nearly 25% of children under the age of 5 in the United States are Latino and 17% of children in this age group are black.3 Consequently, it is important for pediatricians to consider the impact of race and ethnicity on the management of pain in children.
CULTURAL AND ETHNIC DIFFERENCES IN CLINICAL PAIN IN ADULTS
In adults, there is substantial literature focused on the role of ethnicity and race in the experience of pain.4–16 Although there have been some contradictory findings, as a whole this literature suggests ethnic differences in perception, assessment, and treatment across settings and types of pain,11 differences that persist even after controlling for potential confounding variables such as socioeconomic status, gender, age, education, marital status, and psychological variables such as emotional state.4,7–10 Survey research suggests that Hispanic individuals may be less likely than white and black individuals to seek treatment by a physician for pain and black individuals may be more likely than white and Hispanic adults to use prescription medication for the treatment of pain.13 …
Address correspondence to Michelle A. Fortier, PhD, Children's Hospital of Orange County, 505 S Main St, Suite 940, Orange, CA 92868. E-mail: mfortier{at}choc.org
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