Historical, institutional, and social inequities result in health care disparities for traditionally underrepresented and marginalized groups, including their pain management care. For example, a 2018 study of migraines by Befus et al found that the “interplay of race, gender, and social location..[are]…key factors in understanding, diagnosing, and treating migraine…” With this in mind, Professor and Director of the UCSF Neuromodulation Service, Dr. Lawrence Poree, is working closely with the North American Neuromodulation Society (NANS), spearheading their Diversity and Outreach Committee that is focused on addressing disparities in access to neuromodulation therapies for traditionally disadvantaged communities. As part of this effort, outreach programs are being developed across the nation, some by graduates of the UCSF Pain Medicine Fellowship Program, such as by Dr. Kenneth Ike at Emory University. On May 16, Dr. Poree provided a presentation for the outreach program in Oakland, CA, with the help of UCSF Professor of Clinical Neurosurgery, Dr. Line Jacques. This event was sponsored by the Sinkler Miller Medical Association (SNMA), a 40 year old medical society dedicated to the care of disadvantaged populations. Per the SNMA, Dr. Poree discussed “the history of the introduction of opioids to the United States, [and] the connection between the mental health crisis, homelessness and opioid addiction. He also discussed which patient populations are appropriate for neuromodulation as well as the financial benefits of the procedure and the device. The importance of listening to the patient and treating the patient as we would want to be treated was also emphasized.”
For further reading, please find the list of articles below, referenced in Dr. Poree’s presentation.
Green CR, Hart-Johnson T. The impact of chronic pain on the health of black and white men. J Natl Med Assoc. 2010 Apr;102(4):321-31.
Maina IW, Belton TD, Ginzberg S, Singh A, Johnson TJ. A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test. Soc Sci Med. 2018 Feb;199:219-229.
Drwecki BB, Moore CF, Ward SE, Prkachin KM. Reducing racial disparities in pain treatment: the role of empathy and perspective-taking. Pain. 2011 May;152(5):1001-6.
Saloner B, McGinty EE, Beletsky L, Bluthenthal R, Beyrer C, Botticelli M, Sherman SG. A Public Health Strategy for the Opioid Crisis. Public Health Rep. 2018 Nov/Dec;133(1_suppl):24S-34S.
Drug Enforcement Administration. Special Testing and Research Laboratory. Emerging Trends Program. Emerging Threat Report. First Quarter 2019.
Graham RE, Ahn AC, Davis RB, O'Connor BB, Eisenberg DM, Phillips RS. Use of complementary and alternative medical therapies among racial and ethnic minority adults: results from the 2002 National Health Interview Survey. J Natl Med Assoc. 2005 Apr;97(4):535-45.
Green CR, Hart-Johnson T. The adequacy of chronic pain management prior to presenting at a tertiary care pain center: the role of patient socio-demographic characteristics. J Pain. 2010 Aug;11(8):746-54.
Green CR, Hart-Johnson T. The association between race and neighborhood socioeconomic status in younger Black and White adults with chronic pain. J Pain. 2012 Feb;13(2):176-86.
Drwecki BB. Education to identify and combat racial bias in pain treatment. AMA J Ethics. 2015 Mar 1;17(3):221-8.
Goodman A, Fleming K, Markwick N, Morrison T, Lagimodiere L, Kerr T; Western Aboriginal Harm Reduction Society. "They treated me like crap and I know it was because I was Native": The healthcare experiences of Aboriginal peoples living in Vancouver's inner city. Soc Sci Med. 2017 Apr;178:87-94.
Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci U S A. 2016 Apr 19;113(16):4296-301.