Sociocultural Differences in Pain Behavior

Study Notes

Sociocultural Differences in Pain Behavior

Sociocultural factors influence pain behavior, impacting how individuals experience and express pain.
Cross-country comparisons show variability.
- US individuals experience the greatest overall impairment related to chronic back pain.
- Italians and New Zealanders exhibit the second-greatest overall impairment.
- Colombians and Mexicans demonstrate the least overall impairment.
- Reportedly, there's a similar degree of objective impairment across different countries.
Cultural beliefs and practices can significantly affect pain perception and management.
- Studies found that Jewish Americans are more likely to seek help, acknowledge their illness, and take preventative measures, while Mexican Americans might underreport severe symptoms or exaggerate minor ones.
- Irish Americans often exhibit stoicism and may deny pain.
Ethnicity and Health
- In the USA, African Americans face disproportionately higher risks of heart disease, cancer, liver disease, diabetes, pneumonia, and violence-related deaths.
- In Britain, male Asian individuals have a 36% increased risk of Coronary Heart Disease (CHD) compared to the national average, and Asian women show a 46% higher risk.
- Differences in CHD rates were most marked for Asians between 20 and 39 years of age and were two to three times higher than white populations.
- British Afro-Caribbeans exhibit a 76% higher risk of strokes for men and 110% for women.
- Mortality due to hypertension is four times higher in Afro-Caribbeans, and seven times higher for Afro-Caribbean women compared to the national average.
- Cancer rates have historically been lower in Afro-Caribbeans, but the trend is now rising.
- Differences in health behaviors are observed depending on ethnicity.
  - American black women tend to report lower smoking and drinking rates compared to white women.
  - In the UK, few women from minority ethnic groups smoke.
  - Amongst men, alcohol-related health issues are significantly higher for Asians of Punjabi origin.

Interaction of Genetics with Lifestyle

Type II diabetes is a disorder with both genetic and environmental components, including lifestyle and diet.
In the USA, there are approximately 1.5 million people of Native American heritage.
Diabetes prevalence within this population has significantly increased since 1930.
- In the Pima tribe, nearly half of individuals over 35 have diabetes.
According to Kaplan et al (1993), the development of diabetes is linked to obesity.
- Increased weight increases the risk of Type II diabetes.
- Some individuals may be genetically predisposed to the disease, but its development depends on weight.
Maintaining a traditional lifestyle can prevent diabetes onset.
Lifestyle changes, like those imposed by industrial society, cause prevalent diabetes onset.

Ethnicity and Body Size

Ethnicity is linked to differing body sizes.
Cultural factors can play a significant role in influencing perceptions of body size, with African Americans showing increased approval of larger body sizes.
Research identifies that approximately 50% of African American women are obese.
Adolescence is noted for a marked increase in obesity rates for African American females.
Height, weight, and central body skinfold measures are significantly greater for African American girls (aged 9-10) compared to white girls.
Increased physical maturation is linked to different body sizes in African American girls.
Obesity is more prevalent for Mexican Americans than the general population, with rates approximately 4 to 6 times higher among Mexican Americans than whites
Obesity levels among Navajo children is very high.
Genetic and environmental factors' influences on ethnic differences are not yet fully understood.

John Henryism

Black men in high-stress environments (high unemployment, crime, and low income) showed elevated blood pressure compared to those in low-stress environments, but this correlation was absent in white men.
The high blood pressure in black men was interpreted as an active coping mechanism, potentially indicative of the struggle to change or control one's environment. This struggle, even when faced with limited control over the situation can be a form of stress.