Perceived discrimination is associated with chronic pain and depression and contributes to racial health disparities. In a cohort of older adult veterans with osteoarthritis (OA), we analyzed baseline data from 270 African American, and 247 White veterans enrolled in a randomized controlled trial testing a psychological intervention for chronic pain at two VA medical centers. Participants were aged ≥50 years and self‐reported symptomatic knee OA.
Measures included the demographic variables, WOMAC pain subscale, Patient Health Questionnaire Depression Scale (PHQ‐8), and Everyday Discrimination Scale. The cumulative disadvantage was defined as the number of socially disadvantaged groups to which each participant belonged (i.e., self‐reported female gender, African American race, income<$20,000, and unemployed due to disability). We used linear regression models and Sobel’s test of mediation to examine hypotheses. The average number of social disadvantages was 1.3 (SD=1.0). The cumulative disadvantage was significantly associated with higher perceived discrimination, pain, and depression (p’s<.001). Perceived discrimination significantly mediated the association between cumulative disadvantage and depression symptoms (Z=3.75, p<.001) as well as pain severity (Z=2.24, p=.025).
In conclusion, perceived discrimination iwas found to be an essential psychosocial stressor that contributes to poor OA‐related mental and physical health outcomes, with much better effects among those from multiple socially disadvantaged groups.
Ref: https://onlinelibrary.wiley.com/doi/10.1002/acr.24481
