Sociodemographic patterns and associations between perceived healthcare discrimination and pain severity in the All of Us Research Program

作者：Anitha Saravanan, Yuzhou Liu, Grace Mooney, Olubukola Fabusiwa, Staja Q. Booker, Cao Xueyuan, Ericka N. Merriwether, Boshi Zhao, Michael R. Kushnick, Angela Starkweather, Keesha Powell-Roach · 发表于：Journal of Pain · 年份：2026 · DOI：10.1016/j.jpain.2026.106261 · 被引用次数：1 · 研究领域：Musculoskeletal pain and rehabilitation、Pain Management and Opioid Use、Opioid Use Disorder Treatment

Racial, ethnic, and socioeconomic disparities in pain severity and treatment persist across healthcare settings, reflecting inequities shaped by patients' experiences of discrimination and bias. Perceived healthcare discrimination (PHCD), feeling dismissed, disrespected, or treated unfairly by healthcare providers, may contribute to persistent pain disparities among socially disadvantaged populations, yet its independent role relative to everyday discrimination remains underexplored. Using cross-sectional data from the All of Us Research Program, we examined associations between PHCD and pain severity among 89,069 participants from the Registered Tier Dataset (v7, R2022Q4R9), excluding individuals with missing data or non-categorized racial identities. Multinomial logistic regression models adjusted for age, sex, race/ethnicity, income, and education were used to estimate odds ratios (ORs) for pain severity. Both occasional and frequent PHCD were significantly associated with higher odds of mild, moderate, and severe pain (all p <.001). Participants reporting frequent PHCD had nearly eightfold higher odds of severe pain compared with those reporting no discrimination (OR = 7.98, 95% CI: 6.85-9.30). These associations persisted after full covariate adjustment, demonstrating a clear dose-response relationship between discrimination frequency and pain severity. PHCD emerged as a robust and independent predictor of pain severity in a large, diverse national sample, highlighting d...