Patient Race, Ethnicity, Language, and Pain Severity in Primary Care: A Retrospective Electronic Health Record Study.

Findings come from one Midwest primary care clinic, so they may not apply to other settings or populations. Most visits were White, not Hispanic/Latino, and English-speaking, so estimates for smaller groups such as Khmer language may be unstable. Data were retrospective and limited to what was recorded in the electronic health record, so bilingual status, socioeconomic status, immigrant status, acculturation, pain words, and psychosocial factors were not measured. Language and culture could not be separated because the record did not include cultural subgroup, only race, ethnicity, and preferred language. Pain scores were self-reported numbers and may reflect communication needs, reporting style, or the patient's goal in the visit rather than the actual pain experience. The study looked at pain in general, not specific pain types or chronicity, and did not account for psychosocial factors such as depression, anxiety, or stress. Numeric pain scales may not capture pain severity accurately for all groups, including Native American patients.

The authors declared no competing financial interests or personal relationships.

Do not read the higher pain scores in Spanish or Lao visits as proof that language itself causes more pain. The study is observational and did not measure bilingual status, culture, socioeconomic status, or psychosocial factors, so the association may reflect other differences.