Mixed Race Studies

Is Race/Ethnicity Related to Presence or Severity of Pain in Colorectal and Lung Cancer?

Journal of Pain and Symptom Management
Published online: 2014-04-18
DOI: 10.1016/j.jpainsymman.2014.02.005

Kathryn A. Martinez, PhD, MPH, Postdoctoral Fellow
CanSORT (Cancer Surveillance & Outcomes Research Team)
Ann Arbor VA Health Services Research & Development Center,
University of Michgan, Ann Arbor

Claire F. Snyder, PhD, Associate Professor of Internal Medicine
Johns Hopkins Univesity Shchool of Medicine, Baltimore, Maryand

Jennifer L. Malin, MD, PhD
Wellpoint, Thousand Oaks, Calfornia; Jonsson Comprehensive Cancer Center and David Geffen School of Medicine, University of California, Los Angeles

Sydney M. Dy, MD, MSc, Physician Leader, Duffey Pain and Palliative Care Program, Hopkins Kimmel Cancer Center; Associate Professor
Deparmemt of Health Management and Policy
Johns Hopkins Bloomberg School of Public Health

Context

Developing interventions to address racial/ethnic cancer pain disparities requires exploration of the role of socioeconomic status, health status, and pain severity from the time of diagnosis.

Objectives

To examine patterns of disparities in cancer pain by evaluating differences by race/ethnicity in the odds of reporting pain and in pain severity, controlling for key patient-level covariates.

Methods

This study used data from a nationally representative cohort of colorectal and lung cancer patients. Multivariable logistic regression was conducted to examine the relationship between race/ethnicity and reporting pain. Multivariable linear regression was then conducted, among those who reported pain, to determine differences in pain severity by race/ethnicity.

Results

The cohort included 5,761 individuals (14% black, 7% Hispanic/Latino, 6% Asian or Pacific Islander, and 3% multiracial) among whom 48% reported pain. The adjusted odds of reporting differed only for multiracial patients, who were more likely to report pain than whites (OR:1.54; p=0.036). However, among those with pain, severity was higher for black patients (β=6.6; p≤0.001) and multiracial patients (β=4.5; p=0.036) relative to white patients. Lower educational attainment, depressed affect, and lower levels of wealth were also associated with higher pain severity.

Conclusion

While the odds of experiencing pain differed only for multiracial patients, among those reporting pain, both blacks and multiracial individuals reported higher pain severity than whites. Sociodemographic status, health status, and depression were associated with severity but did not explain the disparity. Interventions to address these disparities will need to address reported severity as well as patient-level factors.

Read or purchase the article here.

Opinion: Supreme Court ruling upholds America’s mixed view

Cable News Network (CNN)
2014-04-24

Martha S. Jones, Arthur F Thurnau Professor, Associate Professor of History and Afroamerican and African Studies
University of Michigan

(CNN) — I didn’t expect to find the specter of the mixed-race person making an appearance in Tuesday’s Supreme Court decision that upheld Michigan’s ban on affirmative action.

But there it was.

In Schuette v. Coalition to Defend Affirmative Action, Justice Anthony Kennedy, writing for the plurality, cast doubt upon the court’s capacity to deliberate over race cases — and mixed-raced people were said to be the culprits.

Kennedy wrote that “not all individuals of the same race think alike.” Fair enough. But then he went on to suggest that mixed-race people confound the court’s capacity to “define individuals according to race.”

He continued (PDF), “In a society in which those lines are becoming more blurred, the attempt to define race-based categories also raises serious questions of its own.”

When we blur the lines, as mixed-race people like me are said to do, are we really undermining the court’s capacity to determine questions about the equal protection of the laws?

Kennedy’s view feels familiar: There is nothing new about regarding mixed-race people as a problem in the United States.

We can trace this idea to the earliest lawmaking in British colonial America. The first laws to regulate race were those that prohibited sex and marriage across the color line…

Read the entire opinion piece here.