Towards health equity for people experiencing chronic pain and social marginalization

• Published in: International journal for equity in health Vol. 20; no. 1; p. 53
• Main Authors: Wallace, Bruce, Varcoe, Colleen, Holmes, Cindy, Moosa-Mitha, Mehmoona, Moor, Gregg, Hudspith, Maria, Craig, Kenneth D
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02-02-2021; BioMed Central; BMC
• Subjects: Aggression; Back pain; Biomedicine; Chronic pain; Community‐based participatory research (CBPR); Data collection; Demographics; Discrimination; Domestic violence; Fairness; Focus groups; Harm reduction; Health aspects; Health care; Health disparities; Health equity; Health services; Indigenous; Inequality; Intervention; LGBTQ people; Management; Marginality; Marginality, Social; Mental disorders; Mental health; Pain; Pain management; Participatory research; Public health; Racial discrimination; Racism; Refugees; Risk reduction; Social exclusion; Social justice; Social marginalization; Stigma; Structural violence; Trauma; Violence; Canada; Indigenous; Social marginalization; Health equity; Refugee; Structural violence; Community‐based participatory research (CBPR); Chronic pain; LGBTQ2S
• ISSN: 1475-9276; 1475-9276
• DOI: 10.1186/s12939-021-01394-6

For people who experience social inequities and structural violence, pain and related care are inexorably linked to experiences of injustice and stigma. The purpose of this study was to examine in greater depth the experiences of pain and discrimination and stigma across diverse marginalized communities in order to recommend equity-oriented healthcare approaches.
This community-based qualitative study reports on four focus groups that included 36 people living with pain. All participants identified with one of three groups known to experience high levels of inequities and structural violence including an Indigenous group, a LGBTQ2S group, and two newcomer and refugee groups.
Pain was entangled with and shaped by: social locations and identities, experiences of violence, trauma and related mental health issues, experiences of discrimination, stigma and dismissal, experiences of inadequate and ineffective health care, and the impacts of these intersecting experiences.
Equity-oriented responses to chronic pain would recognize pain not only as a biomedical issue but as a social justice issue. The EQUIP Framework is an approach to integrating trauma- and violence-informed care; culturally-safe care; and harm reduction in health care that may hold promise for being tailored to people experiencing pain and social marginalization.