Associations Between Race and Ethnicity and Treatment for Chronic Pain in the VA

The purpose of this study was to identify racial and ethnic differences in patient-reported rates of treatment for chronic pain and ratings of pain-treatment effectiveness among veterans treated in Veterans Affairs (VA) facilities. This was a cross-sectional analysis of data from 255,522 veterans who participated in the VA Survey of the Healthcare Experiences of Patients (SHEP) in Fiscal Year 2005. Measures included demographics, the Veterans Rand Health Survey-12, a single item inquiring if the patient received treatment for chronic pain in the VA within the prior 12 months, and a single item asking the patient to rate the effectiveness of chronic pain care. In a logistic model adjusting for demographics, pain interference, and mental health status, male and female veterans who were Hispanic (OR 1.39 [95%CI 1.26-1.53] and OR 1.57 [1.02-2.43], respectively) or nonHispanic black (OR 1.43 [1.33-1.54] and OR 1.35 [1.02-1.78], respectively) were more likely to report receiving treatment for chronic pain in the prior 12 months compared to nonHispanic white veterans. Among veterans who reported receiving treatment for chronic pain, nonHispanic black men were less likely to rate pain-treatment effectiveness as very good or excellent, compared to nonHispanic white men (OR .809 [.720-.910]). Perspective: In our study, Hispanic and nonHispanic black veterans reported receiving chronic pain treatment more frequently than white veterans. Among veterans reporting pain treatment, nonHispanic black men were somewhat less likely to report receiving highly effective treatment than white men. Further research is needed to understand the reasons for these differences and their potential clinical implications.