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A Socioecological Framework to Examine Disparities in Pain Care.

Burgess DJ, Hirsch A, Sankar CA. A Socioecological Framework to Examine Disparities in Pain Care. Presented at: American Pain Society Annual Meeting; 2016 May 12; Austin, TX.


Pain care disparities for racial/ethnic minority groups and other vulnerable populations exist at multiple stages of the pain care continuum from access to care, pain assessment, pain treatment, pain management and access to treatment. Despite continued awareness of these disparities, improvement has been difficult due to contributing factors spanning from the individual level to the health care system/societal level. A socioecological framework is useful to examine disparities in pain care from a holistic viewpoint. The socioecological framework presented includes four levels from macro to micro: 1) Healthcare System and Societal Influences, 2) Community/Neighborhood Factors; 3) Relationships: Patient/Provider Interaction and 4) Individual factors. Dr. Campbell will address Individual level factors: Ethnic differences in endogenous pain regulation; Dr. Hirsh will address Patient/Provider level factors: Examination of clinician bias and ambiguity in pain management decisions; and Dr. Burgess will address Healthcare System level factors: Racial differences in prescription of Opioid analgesics for chronic non-cancer pain. The format of the symposium will be a brief 5 minute introduction followed by three 20-minute talks and a 5 minute overarching summary that weaves the 3 talks together in the context of the socioecological model. This will set the stage for an interactive discussion period for the remaining 20 minutes.

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