Title: Racial and Socioeconomic Differences in Chronic Low Back Pain
Funded by the National Institute on Minority Health and Health Disparities (R01MD017565) PI: Goodin, Washington University School of Medicine, St. Louis, Site PI: Morris, Vanderbilt University Medical Center
The worldwide point prevalence of activity-limiting (acute and chronic) low back pain (cLBP) is approximately 12%, which equates to approximately 933 million people globally suffering with low back pain at any given time. Objective measures of disease activity in cLBP have not consistently been strong predictors of clinical symptoms, therefore cLBP provides an excellent model for investigating the influence of social determinants such as racial background and social stress on the progression of pain and disability over time. Our group found evidence that non-Hispanic Black (NHB) individuals with cLBP reported significantly greater pain severity and disability than their non-Hispanic White (NHW) counterparts, and that racial disparities in cLBP were exacerbated by low socioeconomic status (SES). In this study we will prospectively assess the two-year progression of clinical pain and disability, as well as pain-relevant psychosocial functioning among NHBs and NHWs with cLBP using minority stress theory and a recently developed resilience framework.
Funded by the National Institute on Minority Health and Health Disparities (K01MD020122) PI : Kinney, Vanderbilt University Medical Center
Generalized anxiety disorder (GAD), the most prevalent anxiety disorder in primary care, is often misdiagnosed, particularly in individuals from marginalized sociodemographic groups. The proposed study leverages large-scale, epidemiologic and electronic health record datasets to evaluate two potential contributors to GAD diagnostic disparities: 1) psychometric bias, or indications that GAD’s diagnostic criteria fail to capture the same construct across sociodemographic groups or over time, and 2) disparities in patient-centered care, which is characterized by collaborative decision-making and respecting patients’ values, culture, and context. Findings from the proposed study will inform efforts to achieve equitable GAD diagnostic practices and treatment access by illuminating how minoritized groups experience GAD and how it can be accurately diagnosed.