Pain in Persons Who Are Marginalized by Social Conditions

Kenneth D. Craiga; Cindy Holmes; Maria Hudspith; Gregg Moor; Mehmoona Moosa-Mitha; Colleen Varcoe; Bruce Wallace


Pain. 2020;161(2):261-265. 

In This Article

Abstract and Introduction


Pain is often poorly recognized, inadequately assessed, and unsuccessfully managed among people in mainstream society,[7,40] but this is particularly the case for people who have been historically, economically, and socially marginalized,[39,46] although access to pain management is considered a basic human right.[10,53] People who are indigenous, recent immigrants or refugees, of colour, LGBTQ2S, less well educated, living with mental health or substance-use challenges, or have experienced violence and trauma, among others, are vulnerable to a higher prevalence of painful medical conditions, relative to nonmarginalized people, as well as to experiencing barriers to pain management services.[80,86] This study addresses the challenges of providing access to pain management for people who have been socially and economically marginalized and emphasizes the need for care at the intersection of 2 bodies of knowledge: the broad biopsychosocial model of health, given that social determinants of pain are of conspicuous importance in these populations,[8,21,22,54,87] and the growing understanding of the intersections between trauma, violence, substance use, and pain.[67] Those who face stigmatization and marginalization are at risk for not receiving health and social benefits broadly available to the population at large.[5,6,34,38,64,85]