February marks African American History Month, a time to honor the nation’s black heritage and recognize the community’s struggle to gain rights equal to all U.S. citizens. Today, despite being equal in the eyes of the law, African Americans continue to experience high levels of poverty, reduced access to medical care, and poorer outcomes when it comes to the treatment of chronic pain, according to a report by pain advocacy group In the Face of Pain.

How African American History Month began

In 1925, when the seeds of African American History Month as we know it today were planted, race relations in the U.S. were horrendous. Black people were regularly lynched, Ku Klux Klan membership was on the rise, and race riots were common, sometimes for something so simple as an African American entering a beach designated for whites only, according to the British Broadcasting Corporation.

Racial segregation was alive and well throughout the country, with separate facilities reserved for people of varying races for everything from beaches to bathrooms.

However, African Americans were mobilizing and efforts to gain equal recognition were expanding. In 1925, members of the Association for the Study of Negro Life and History, including founder Carter G. Woodson, a historian and Harvard graduate, developed the idea for Negro History Week.

The inaugural week was celebrated in February 1926, the month chosen because it contained the birthdays of Abraham Lincoln and Frederick Douglas, a man who escaped slavery and became an abolitionist leader, according to the Library of Congress.

Some of the U.S. public initially embraced the idea and the celebration expanded through the 1960s, when social change was transforming many facets of life, including race relations. By that time, mayors of cities and towns nationwide were declaring their official support for Negro History Week, a move that dovetailed with the emerging civil rights movement.

In 1976, when the nation turned 200 and Negro History Week celebrated its 50th birthday, the celebration expanded to include all of February and was re-named African American History Month. The association that initiated the movement still exists today, but has been renamed the Association for the Study of African American Life and History.

What happens during African American History Month?

Each February, during this time of recognition and appreciation, leaders and educators all over the nation take the opportunity to honor the contributions of African Americans while also recognizing that the work of racial equality is not over.

The Library of Congress offers free educational material available to teachers, including links to images and National Archives. Explore fascinating pieces of history on the archives, like a letter to President Abraham Lincoln written during the Civil War by an enslaved woman named Annie Davis who asked if she was free.

The National Archives features images of original documents and suggested lesson plans, but the reading material may be of interest even if you’re not a teacher.

African Americans and chronic pain

In addition to celebrating heritage, African American History Month offers the opportunity to raise awareness around quality of life issues for the African American community, including poor health outcomes for those experiencing chronic pain, diminished access to health care, and cultural issues impeding effective treatment.

A study published in the Journal of Pain found African Americans with chronic pain were more likely to report worse pain than their white counterparts, and they were also more likely to be disabled.

Chronic pain is complex and can stem from a variety of primary conditions. However, regardless of its cause, African American patients report more pain than patients of other races, according to a book called Relieving Pain in America by the Institute of Medicine.

Part of the disparity may be attributed to greater pain sensitivity, the book says, however researchers also believe cultural coping strategies may differ. Another potential issue is the pattern of distrust by African Americans toward doctors because medical researchers have, in the past, exploited the community.

Chronic pain treatment for the African American community is frequently subpar, partly because of little-understood cultural differences.

A disparity in pain medication may also be influenced by culture. African Americans face higher rates of untreated pain than white people, according to Relieving Pain in America. A study the authors quote found that African Americans who visit the doctor for long-bone fractures were almost two times more likely than whites to leave without pain medication. And in nursing homes, black residents with cancer pain were 63% more likely than whites to go without pain medication.

One possible explanation is that African Americans may have a greater fear of addiction than white people, according to In the Face of Pain. But more hidden is a prevalent cultural belief that taking pain medication is weak. One should bear their pain with strength, the advocacy group says many believe.

That could be why one study cited by In the Face of Pain showed more than 80% of African Americans waited to call their doctors until pain levels reached a ten on a scale of ten.

Access to care is another big issue, although the Affordable Care Act (ACA) is changing that by making affordable or no-cost insurance available to millions of people. In 2013, before the ACA, blacks were 55% more likely than whites to be uninsured, and about 17% of all African Americans lacked health insurance, according to the Department of Health and Human Services.

About 62% of uninsured African Americans also live in poverty, another impediment to receiving quality healthcare. In the Face of Pain authors write:

“Minorities were twice as likely to feel they did not get the treatment for pain that they needed since they could not afford it.”

On a positive note, African Americans don’t necessarily experience pain in greater numbers than other races. African Americans are slightly more likely to suffer from headaches or migraines than whites, but less likely to develop arthritis or pain in the low back or neck, according to In the Face of Pain.

What are your thoughts about the disparities in chronic pain care for the African American community?

Image by Jackie Finn-Irwin via Flickr

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