Pain, socioeconomic status and clinician assessments: a scoping review

Pain is a significant burden to societies worldwide with as many as one in three people believed to be living in chronic pain. However, pain is not a burden that is equally shared. Women, People of Colour, and people with low socioeconomic circumstances present with more frequent and more intense levels of chronic pain. The relationship between pain and socioeconomic status is not fully understood. This review aims to examine if patient socioeconomic status influences healthcare providers' assessment of pain. A five-stage method was used to gather and report the results. Seven electronic databases and two sources of grey literature were searched in September 2020. After review, thirteen suitable studies were identified - Nine American, one Brazilian, one Portuguese and one from the UK. Results showed that while SES does appear to have an effect on healthcare practitioners' assessment of pain, that affect is complex and interdependent upon other social determinants of health, especially race. It can be surmised, however, that patients with low SES are less likely to have a pain assessment performed or recorded, and their pain will likely be considered less credible, less intense and more related to psychological causes - especially in the presence of distress cues.

Automated summary

Pain is a significant burden to societies worldwide, and the assessment of pain by healthcare providers may be influenced by patient socioeconomic status. This review explores the complex relationship between socioeconomic status and healthcare practitioners' assessment of pain.