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Vo, Anh Khoa

University of British Columbia

Background: Historically, race was believed to be biologically determined, which has permeated various facets of society, including health care and health research. Despite the contemporary notion of race as a social construct lacking a biological basis, racial disparities continue to exist in health outcomes and participation in health research. However, there are knowledge gaps with respect to racial disparities within the field of acute and chronic pain. Objective: To examine racial differences in health outcomes and health research participation within the framework of race as a social construct, and with a focus on acute and chronic pain contexts. Methods: Data were compiled from various sources including the Healthcare Cost and Utilization Project, Canadian Community Health Survey, Clinicaltrials.gov, PubMed, and others. Several analytical methods were used, including: multivariable logistic regression, multivariable linear regression, and causal mediation analysis. Results: Findings from Chapter 4 showed that emergency department visits (for complex regional pain syndrome type 1) by Black individuals were significantly negatively associated with immediate hospitalization and hospitalizations by Black patients were independently associated with increased length of stay. Chapter 5 demonstrated that racialized individuals in Canada were less likely to use prescription opioids (compared with non-racialized individuals), even after adjusting for potential confounders. In Chapter 6, the results showed that less than half of pain clinical trials in the US reported race, and that sample size, year of publication, and funding sponsorship were associated with race reporting practices. Moreover, Black participation in pain clinical trials aligned with national demographics in the US, with increased representation corresponding with health conditions more prevalent among Black individuals (e.g., cardiovascular disease) and with a diverse study team composition. Chapter 7 revealed that racialized individuals were less inclined to support open data sharing than non-racialized individuals, a relationship mediated by trust. Implications: In short, this thesis highlights the persistence of racial disparities in health care and health research, and underscores the multifaceted factors underlying these disparities. Further, it emphasizes the need to address race-based discrimination to achieve health equity for racialized groups.

Text

2024-07-25

10.14288/1.0444816

Doctor of Philosophy - PhD

Pharmaceutical Sciences, Faculty of

2024-11

Graduate