Pain Disparities Attributed to Linguistic Minoritization in Health Care Settings

Paulina S Lim; Michelle A Fortier; Zeev N Kain

doi:10.1016/j.jpain.2024.104688

Pain Disparities Attributed to Linguistic Minoritization in Health Care Settings

J Pain. 2024 Sep 30:104688. doi: 10.1016/j.jpain.2024.104688. Online ahead of print.

Authors

Paulina S Lim¹, Michelle A Fortier², Zeev N Kain³

Affiliations

¹ Department of Anesthesiology and Perioperative Care, University of California, Irvine, California; UCI Center on Stress and Health, University of California Irvine, Irvine, California. Electronic address: palim1@hs.uci.edu.
² UCI Center on Stress and Health, University of California Irvine, Irvine, California; Sue and Bill Gross School of Nursing, University of California Irvine, Irvine, California; Children's Hospital of Orange County, Orange, California.
³ Department of Anesthesiology and Perioperative Care, University of California, Irvine, California; UCI Center on Stress and Health, University of California Irvine, Irvine, California; Children's Hospital of Orange County, Orange, California.

PMID: 39357614
DOI: 10.1016/j.jpain.2024.104688

Abstract

There is a paucity of understanding about how language influences pain communication and outcomes for families who speak languages other than English in the United States. This is of great importance because 21.6% (68 million) of the population speak a language other than English, with 8% (25 million) of the population speaking English "less than very well." Thus, the aim of this paper is to present a narrative review that describes how spoken language influences pediatric pain assessment and outcomes for children who speak languages other than English and discuss hypothesized factors that contribute to pain disparities in hospital settings. Results from the narrative review reveal that children and families who speak languages other than English have disparate pain outcomes compared with children from English-speaking families. It is hypothesized that individual (eg, clinician bias), interpersonal (eg, miscommunication of pain concepts), cultural (eg, misunderstanding of cultural concepts of pain), and systemic (eg, lack of access to interpretation services) factors influence disparate pain outcomes for linguistically minoritized children. Empirical research, including randomized control trials, regarding hypothesized factors that contribute to pediatric pain disparities for language other than English-speaking children, is severely lacking. Thus, improved understanding of pain concepts and pain communication processes that center individual, interpersonal, cultural, and systemic factors will enable future research to design interventions that enhance culturally relevant pain assessment and management for families who speak languages other than English. PERSPECTIVE: This article summarizes factors that contribute to pain disparities for children who speak languages other than English. Hypothesized factors that contribute to pain disparities for language other than English-speaking children and families include clinician bias, misunderstanding of pain concepts, and lack of access to interpretation services.

Keywords: Limited English proficiency,language other than English,pediatric pain,pain equity,language barriers.