The Influence of Race, Sex, and Social Disadvantage on Self-reported Health in Patients Presenting With Chronic Musculoskeletal Pain.
Abby L Cheng, Ethan C Bradley, Brian K Brady and 4 others
PMID 33935150WHAT IT FOUND
Living in socially disadvantaged neighborhoods was linked to worse physical function, pain interference, anxiety, and depression in patients with chronic musculoskeletal pain.
Black race was linked only to higher anxiety, and female sex only to lower physical function. These associations were independent of age and opioid use.
Key findings
01Disparate social disadvantage was independently associated with clinically meaningfully worse self-reported physical and behavioral health in all domains assessed.
02Black race was independently and meaningfully associated with greater anxiety than white race, and female sex was associated with worse physical function than male sex.
03Compared to less disadvantaged communities, a relatively greater proportion of Black and female patients lived in the most disadvantaged communities.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study is cross-sectional and cannot establish causality. The sample was derived from a single institution, limiting generalizability. Race categories were condensed to White, Black, and Other, and sex was recorded as binary, excluding gender identity. The sociodemographic variables explained only a small portion of the variance in health outcomes (R² = 0.06–0.11). PROMIS scores are standardized against a general US population, which may not accurately reflect the baseline of specific local communities with different demographic distributions.
Declared interests
None of the authors have conflicts of interest or competing interests to disclose.
The easy way to misread this
Do not assume that race or sex are the primary drivers of worse health outcomes in isolation. The study found that social disadvantage was the consistent variable associated with worse outcomes across all domains, while race and sex had more specific, limited associations. Additionally, Black and female patients were disproportionately found in disadvantaged areas, suggesting that social environment may be a key mediator.