Ten years ago, Jaime Sanders started Migraine Diva, a blog about her experiences as a young black woman with chronic migraine headaches. Her vulnerability and transparency about her life, including dealing with chronic pain, depression and anxiety, and managing a household that includes her husband and children, have earned her a devoted following.
A major conference soon followed. In 2016, the company invited him to speak at a writing conference on migraine. This awareness has led to increased awareness and participation of Migraine and the Migraine Patients Association (CHAMP). Sanders quickly became part of a national conversation about the importance of providing specialized, targeted care to migraine patients, but he knew a critical perspective was missing.
“I have insurance, I have a checking account and supplemental insurance, and I’m still struggling,” Sanders said. “I have to drive two hours to see a headache specialist just for a nerve block and filler, but I can do it. I’m lucky enough to do it, but not everyone can do it. I need to talk about it and think about it.” those people. You can’t.”
Sanders’ willingness to advocate for those marginalized in pain care has helped her shift her advocacy to actively addressing the systemic barriers women and women of color face when seeking help. As a member of CHAMP’s Mental Health Diversity Advisory Council (DiHAC), Sanders helps people who lack transportation or live in remote areas brainstorm solutions with a neurologist to get the best treatment possible.
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There is also an urgent need to ensure that underserved patients are diagnosed with headaches or migraines and that their problems are taken seriously; because research has shown that the majority of white doctors believe black patients are less likely to experience pain. Other studies have shown that doctors can misdiagnose pain in black and white patients because they cannot measure pain in their faces.
Differences in treatment of women
Despite the report and countless anecdotes of untreated pain from women of all races and ethnic groups, published research on gender differences in pain management remains sparse, according to Diane Hoffmann, Professor of Health Law and Chair of the Department of Law and Health. program at the University of Maryland.
Hoffmann’s 2001 article The Girl Who Learned Pain: Bias Against Women in Pain Management Summary Research has shown that women are less likely to receive effective treatment for their pain, even though theyexperience more severe and frequent pain than men. It has also been found that healthcare providers are biased against women’s verbal descriptions of pain when no physical cause can be measured or diagnosed.
Two decades later, Hoffmann is working on a new paper examining the current state of pain management in women, but says the research is still limited.
“There is still a lot of research on how women cope with pain,”
said. “I don’t know if researchers find this topic interesting anymore or if they can fund this type of research, but there are actually more papers onthis topic in other countries than in the United States, which basically found that women were not being treated well because of their pain.”
The opioid crisis from the mid-1990s to the late 2010s also had a significant impact on how healthcare providers treat pain; many people began refusing to prescribe opioids. Although this warning helped prevent drug addiction, it also eliminated treatment options for some patients.
But Hoffmann hopes that more research and discussion at the intersection of race and pain management, and the integration of pain management training into more medical school programs, will lead to better treatments for women and people of color. Some colleges and universities in the United States offer more detailed training in pain management in their regular programs than they did a decade ago, and some are developing master’s or
degree programs in pain management for healthcare providers.
Promoting equity in pain management
Pain Relief Stories Don’t tell Sanders: You’ve been through the same thingsand felt the same things as other black women.
“I’ve heard this way of talking a lot,” Sanders said. “After the birth of my first child, the doctor tried to give me an injection without local anesthesia. He was shocked when I heard this and I almost kicked him. It took me until recently to be able to combine this with the work I do. This is my personal experience with pain. “
Last summer’s protests following the police killing of George Floyd highlighted longstanding concerns of people of color and helped galvanize DiHAC’s work. CHAMP has helped fund eight programs at U.S. universities and colleges, including historically black institutions, that invite pain patients to talk to medical students about their experiences in the healthcare system. Sanders would like to see more direct work with Indigenous and inner-city communities on pain management through cultural and community initiatives.
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Cultural competency should be included in pain management education so that healthcare professionals can better understand how the patient’s culture influences their beliefs about the treatment process, their verbal and nonverbal communication of pain, and their desire to consume traditional medications and foods. It is a comprehensive treatment plan.
Sanders said: “I always think about the things we don’t think about, and that’s the person in the marginalized group.” “I’m in a group that’s marginalized just because I’m black, but you can be white in Appalachia and you can be marginalized because you live in rural America. Your zip code defines your life. We need to talk about that.”