# Racial and Socioeconomic Differences in Chronic Low Back Pain

> **NIH NIH R01** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2020 · $573,506

## Abstract

Project Summary/Abstract
Chronic pain affects more than 100 million people in the United States and produces annual costs up to $635
billion. While pain affects all segments of the population, the burden of chronic pain and associated disability
disproportionately affects non-Hispanic Blacks (“Blacks”) compared to non-Hispanic Whites (“Whites”) as well
as individuals with low socioeconomic status (SES) compared to those with high SES. Blacks often experience
more frequent, severe and disabling chronic pain compared to Whites. Further, SES factors, such as lower
levels of education, low income, and unemployment are associated with higher rates of chronic and disabling
pain. Despite growing documentation of racial differences in chronic pain outcomes, relatively little research
has focused on differences in the experience of chronic low back pain (cLBP) between Blacks and Whites in a
socioeconomic context. This is concerning because cLBP is one of the most prevalent and severely disabling
painful conditions, yet it remains unclear whether specific disadvantaged subgroups of society such as Blacks
with low SES may be at heightened risk for poor cLBP outcomes. The proposed hypotheses are based on the
theory of fundamental causes as a socioeconomic framework for explaining why cLBP severity and disability,
as well as the factors predicting these outcomes, may differ as a function of racial background. Guided by the
theory of fundamental causes, the overall aim of this study is to characterize racial and SES differences in
cLBP severity and disability. Further, we aim to examine important biopsychosocial predictors of racial and
SES differences in cLBP outcomes. To explore this overall aim, we will first characterize racial and SES
differences in cLBP clinical symptoms, perceived disability, and functional performance. Next, we will invoke
endogenous pain inhibitory and facilitatory processes using quantitative sensory tests of conditioned pain
modulation and temporal summation, respectively. Biologically-driven factors including sleep, vitamin D,
oxytocin, and C-reactive protein, in addition to psychosocial factors including depressive symptoms, racial
discrimination, perceived injustice, access to social support, and psychological resilience will then be
assessed. We will determine whether endogenous pain modulatory processes, as well as important
biopsychosocial factors differentially predict cLBP outcomes for Blacks and Whites, and whether the strength
of prediction varies according to SES. This study will be the first to directly and comprehensively apply a
socioeconomic framework to the study of racial differences in cLBP outcomes. The findings will also provide
novel and important information regarding biopsychosocial predictors of racial and SES differences in clinical
pain responses and related disability among those with cLBP. Whether these biopsychosocial predictors may
subsequently serve as viable treatment targets for cLBP tailored to meet...

## Key facts

- **NIH application ID:** 9850489
- **Project number:** 5R01MD010441-04
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Burel R. Goodin
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $573,506
- **Award type:** 5
- **Project period:** 2017-04-26 → 2022-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9850489

## Citation

> US National Institutes of Health, RePORTER application 9850489, Racial and Socioeconomic Differences in Chronic Low Back Pain (5R01MD010441-04). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9850489. Licensed CC0.

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