Pain disparities attributed to linguistic minoritization in health care settings

• Published in: The journal of pain p. 104688
• Main Authors: Lim, Paulina S., Fortier, Michelle A., Kain, Zeev N.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 30.09.2024
• Subjects: language barriers; language other than English; limited English proficiency; pain equity; pediatric pain; pediatric pain; pain equity; language barriers; limited English proficiency; language other than English
• ISSN: 1526-5900; 1528-8447; 1528-8447
• DOI: 10.1016/j.jpain.2024.104688

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 manuscript 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 to children from English-speaking families. It is hypothesized that individual (e.g., clinician bias), interpersonal (e.g., miscommunication of pain concepts), cultural (e.g., misunderstanding of cultural concepts of pain) and systemic (e.g., 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. 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 LOE-speaking children and families include clinician bias, misunderstanding of pain concepts, and lack of access to interpretation services. •Children who speak languages other than English have disparate pain outcomes compared to English-speaking children.•Pain disparities are attributed to individual, interpersonal, cultural, and systemic factors.•Examples of factors include bias, cultural understanding of pain, and access to interpreters.•Upstream factors (social and political determinants of health) also result in pain inequities.