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. 2025 Jun 24:10.1097/j.pain.0000000000003676.
doi: 10.1097/j.pain.0000000000003676. Online ahead of print.

Over 50 years of research on social disparities in pain and pain treatment: a scoping review of reviews

Hanna Grol-Prokopczyk  1 , Rui Huang  1 , Chang Yu  1 , Yu-An Chen  1 , Sirat Kaur  1 , Merita Limani  2 , Ting-Hui Lin  1 , Anna Zajacova  2 , Zachary Zimmer  3 , Penney Cowan  4 , Roger B Fillingim  5 , Jennifer S Gewandter  6 , Ian Gilron  7 , Adam T Hirsh  8 , Gary J Macfarlane  9 , Salimah H Meghani  10 , Kushang V Patel  11 , Ellen L Poleshuck  6 , Eric C Strain  12 , Frank J Symons  13 , Ursula Wesselmann  14 , Robert H Dworkin  6 , Dennis C Turk  11
Affiliations

Over 50 years of research on social disparities in pain and pain treatment: a scoping review of reviews

Hanna Grol-Prokopczyk et al. Pain. .

Abstract

Research on social disparities in pain and pain treatment has grown substantially in recent decades, as reflected in a growing number of review articles on these topics. This scoping review of reviews provides a macrolevel overview of scholarship in this area by examining what specific topics and findings have been presented in published reviews. We searched CINAHL, Cochrane Database of Systematic Reviews, Embase, PsycINFO, PubMed, and Web of Science for English-language, peer-reviewed review articles, qualitative or quantitative, that aimed to characterize or explain pain-related differences or inequities across social groups. Of 4432 unique records screened, 397 articles, published over a 56-year period, were included. For each, we documented (1) axes of social difference studied (eg, sex/gender, race/ethnicity), (2) pain-related outcomes (eg, chronic pain prevalence), (3) broad findings, (4) types of mechanisms proposed, and (5) policy or practice recommendations. Findings reveal a sharp increase in the number of published review articles on pain-related disparities since approximately the year 2000. The most commonly studied social dimension was sex/gender, followed by race/ethnicity and age. Studies examining disparities by socioeconomic status, geography, or other categories were rarer. While most findings showed disadvantaged social groups to have worse pain outcomes, there were intriguing exceptions. Biological, psychological, and sociocultural mechanisms were considered much more frequently than sociostructural (macrolevel) ones. Policy/practice recommendations were typically individual-level behavioral suggestions for providers or patients. We identify high-priority areas for future research, including greater attention to lower-income countries, chronic pain prevention, and macrolevel drivers of pain disparities.

Keywords: Health inequities; Pain disparities; Pain epidemiology; Sociodemographic disparities.

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Conflict of interest statement

CONFLICTS OF INTEREST

R.D. has received in the past 5 years research grants and contracts from the US Food and Drug Administration and the US National Institutes of Health, and compensation for serving on advisory boards or consulting on clinical trial methods from Abide, Acadia, Akigai, Allay, AM-Pharma, Analgesic Solutions, Asahi Kasei, Beckley, Biogen, Biosplice, Bsense, Cardialen, Centrexion, Chiesi, Clexio, Collegium, CombiGene, Confo, Contineum, Decibel, Eccogene, Editas, Eli Lilly, Emmes, Encoded, Endo, Epizon, Ethismos (equity), Eupraxia, Exicure, GlaxoSmithKline, Glenmark, Gloriana, Hope, JucaBio, Kriya, Lotus, Mainstay, Merck, Mind Medicine (also equity), Neurana, NeuroBo, Noema, Novaremed, Novartis, OliPass, Orion, Oxford Cannabinoid Technologies, Pfizer, Q-State, Regenacy (also equity), Rho, Sangamo, Sanifit, Scilex, Semnur, SIMR Biotech, Sinfonia, SK Biopharmaceuticals, Sollis, SPM Therapeutics, SPRIM Health, Tiefenbacher, Validae, Vertex, Vizuri, and WCG. In the past 36 months, J.G. has received consulting income from Algo Therapeutix, Eikonizo Therapeutics, Eli Lilly, GW Pharma, Hoba Therapeutics, Neurometrix, and Saluda Medical. She owns vesting shares in Eisana Corp. She has also received personal compensation for serving as Associate Editor for the Clinical Journal of Pain. I.G. has received support from Vertex and Combigene, and has received grants from the Canadian Institutes of Health Research, Physicians’ Services Incorporated Foundation, and Queen’s University. Over the last three years, E.S. has had grant funding to his institution from NIH; editing payments from: Wolters-Kluwer; consulting fees from: Pear Therapeutics (ended), Eli Lilly and Company; honoraria for talks: Rutgers University (ended); medical devices supplied to his institution for his research: Masimo; and he has conducted medical-legal consultations. He also has served on the board of directors (unpaid) for a treatment program: Ashley Addiction Treatment. D.T. has received in the past 5 years research grants and contracts from the US Food and Drug Administration, the US National Institutes of Health, the US National Institute of Occupational Safety and Health, and compensation for serving on advisory boards or consulting on clinical trial methods from GSK/Novartis and Vertex. He has also received compensation as the Editor-in-Chief of The Clinical Journal of Pain and as Associate Director of Analgesic, Anesthetic, and Addiction Clinical Trials Innovations, Opportunities, and Networks (ACTTION). U.W. serves on the External Consultant Board for the “NIH Preclinical Screening Platform for Pain” (NIH/NINDS). In her capacity as a special government employee of the US Food and Drug Administration (FDA), she has served as a voting member of the FDA Anesthetic and Analgesic Drug Products Advisory Committee. In the past 3 years she has received compensation for serving on advisory boards or for consulting activities for Aphrodite Health Inc., Wilmington, DE, Avenue Therapeutics Inc., New York, NY, Bayer Aktiengesellschaft, Leverkusen, Germany, Biohaven Pharmaceuticals, New Haven, CT, Seikagaku Corporation, Tokyo, Japan, and Syneos Health, Morrisville, NC, all unrelated to the submitted work. Other authors report no conflicts of interest.

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