Biobehavioral Pain Research Laboratory

Disparities in the pain experience and pain management based upon minority status have been well documented. Despite decades of research revealing the profound extent and effects of these disparities, little is known about underlying mechanisms that promote disparities. Examination of the social determinants of pain disparities — the environmental conditions and context within which people develop and live that influence pain — holds promise to identify social mechanisms that contribute to and help maintain pain disparities. Examples of social factors that may contribute to pain disparities include:

• stigmatization and discrimination based upon gender, ethnicity/race, age, disability and health status (among others);
• degree of social/community support;
• low socioeconomic status; and
• exposure to trauma resulting from residence in disordered neighborhoods with high levels of crime and violence.

Mechanistic knowledge of the impact of social factors will not only propel the field of pain disparities research bey ond an examination of group differences, but may importantly guide the development of social targets to support pain treatment — particularly among those who continue to bear an unequal burden of pain.

Social Neuroscience

As neuroscience matures, it has become increasingly ap parent that the nervous system cannot be considered as an isolated entity, without consideration of the social environments in which humans live. We now increasingly recognize the considerable impact that social structures have on brain and body function. Social influences operate on the individual through a continuous interplay of neural, neuroendocrine, metabolic, and immune factors on brain and body, in which the brain is the central regulatory organ and also a malleable target of social influences. Recognizing this, the field of social neuroscience was born. Social neuroscience is the interdisciplinary academic field devoted to understanding how biological systems implement social processes and behavior, and how these social structures and processes impac t the brain and biology. A fundamental assumption underlying social neuroscience is that all social behavior is implemented biologically.

In our Biobehavioral Pain Research Laboratory, we utilize a social neuroscience framework to help guide our understand ing of the mechanisms that drive pain disparities. For instance, work by our group has previously demonstrated that experiences of racial discrimination are associated with altered central nervous system processing of noxious stimuli in African Americans with painful knee osteoarthritis. Relatedly, we have recently shown that high levels of internalized health — related stigma promote depression and inflammatory cytokine proliferation in persons living with HIV and chronic pain. Ultimately, the goal of our research is to increas e awareness of the influence of social factors on pain physiology and perception. This knowledge may encourage other researchers, clinicians, and policy makers to consider how social factors affect pain and move beyond a view of disparities in pain experience s as intractable or inevitable.