Racial discrimination in medical care settings and opioid pain reliever misuse in a U.S. cohort: 1992 to 2015.

<h4>Background</h4>In the United States whites are more likely to misuse opioid pain relievers (OPRs) than blacks, and blacks are less likely to be prescribed OPRs than whites. Our objective is to determine whether racial discrimination in medical settings is protective for blacks agains...

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Autores principales:	Samuel L Swift, M Maria Glymour, Tali Elfassy, Cora Lewis, Catarina I Kiefe, Stephen Sidney, Sebastian Calonico, Daniel Feaster, Zinzi Bailey, Adina Zeki Al Hazzouri
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2019
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/47bf98722c1347bbb0846323517fa3ea
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spelling	oai:doaj.org-article:47bf98722c1347bbb0846323517fa3ea2021-12-02T20:07:22ZRacial discrimination in medical care settings and opioid pain reliever misuse in a U.S. cohort: 1992 to 2015.1932-620310.1371/journal.pone.0226490https://doaj.org/article/47bf98722c1347bbb0846323517fa3ea2019-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0226490https://doaj.org/toc/1932-6203<h4>Background</h4>In the United States whites are more likely to misuse opioid pain relievers (OPRs) than blacks, and blacks are less likely to be prescribed OPRs than whites. Our objective is to determine whether racial discrimination in medical settings is protective for blacks against OPR misuse, thus mediating the black-white disparities in OPR misuse.<h4>Methods</h4>We used data from 3528 black and white adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study, an ongoing multi-site cohort. We employ causal mediation methods, with race (black vs white) as the exposure, lifetime discrimination in medical settings prior to year 2000 as the mediator, and OPR misuse after 2000 as the outcome.<h4>Results</h4>We found black participants were more likely to report discrimination in a medical setting (20.3% vs 0.9%) and less likely to report OPR misuse (5.8% vs 8.0%, OR = 0.71, 95% CI = 0.55, 0.93, adjusted for covariates). Our mediation models suggest that when everyone is not discriminated against, the disparity is wider with black persons having even lower odds of reporting OPR misuse (OR = 0.63, 95% CI = 0.45, 0.89) compared to their white counterparts, suggesting racial discrimination in medical settings is a risk factor for OPR misuse rather than protective.<h4>Conclusions</h4>These results suggest that racial discrimination in a medical setting is a risk factor for OPR misuse rather than being protective, and thus could not explain the seen black-white disparity in OPR misuse.Samuel L SwiftM Maria GlymourTali ElfassyCora LewisCatarina I KiefeStephen SidneySebastian CalonicoDaniel FeasterZinzi BaileyAdina Zeki Al HazzouriPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 14, Iss 12, p e0226490 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Samuel L Swift M Maria Glymour Tali Elfassy Cora Lewis Catarina I Kiefe Stephen Sidney Sebastian Calonico Daniel Feaster Zinzi Bailey Adina Zeki Al Hazzouri Racial discrimination in medical care settings and opioid pain reliever misuse in a U.S. cohort: 1992 to 2015.
description	<h4>Background</h4>In the United States whites are more likely to misuse opioid pain relievers (OPRs) than blacks, and blacks are less likely to be prescribed OPRs than whites. Our objective is to determine whether racial discrimination in medical settings is protective for blacks against OPR misuse, thus mediating the black-white disparities in OPR misuse.<h4>Methods</h4>We used data from 3528 black and white adults in the Coronary Artery Risk Development in Young Adults (CARDIA) study, an ongoing multi-site cohort. We employ causal mediation methods, with race (black vs white) as the exposure, lifetime discrimination in medical settings prior to year 2000 as the mediator, and OPR misuse after 2000 as the outcome.<h4>Results</h4>We found black participants were more likely to report discrimination in a medical setting (20.3% vs 0.9%) and less likely to report OPR misuse (5.8% vs 8.0%, OR = 0.71, 95% CI = 0.55, 0.93, adjusted for covariates). Our mediation models suggest that when everyone is not discriminated against, the disparity is wider with black persons having even lower odds of reporting OPR misuse (OR = 0.63, 95% CI = 0.45, 0.89) compared to their white counterparts, suggesting racial discrimination in medical settings is a risk factor for OPR misuse rather than protective.<h4>Conclusions</h4>These results suggest that racial discrimination in a medical setting is a risk factor for OPR misuse rather than being protective, and thus could not explain the seen black-white disparity in OPR misuse.
format	article
author	Samuel L Swift M Maria Glymour Tali Elfassy Cora Lewis Catarina I Kiefe Stephen Sidney Sebastian Calonico Daniel Feaster Zinzi Bailey Adina Zeki Al Hazzouri
author_facet	Samuel L Swift M Maria Glymour Tali Elfassy Cora Lewis Catarina I Kiefe Stephen Sidney Sebastian Calonico Daniel Feaster Zinzi Bailey Adina Zeki Al Hazzouri
author_sort	Samuel L Swift
title	Racial discrimination in medical care settings and opioid pain reliever misuse in a U.S. cohort: 1992 to 2015.
title_short	Racial discrimination in medical care settings and opioid pain reliever misuse in a U.S. cohort: 1992 to 2015.
title_full	Racial discrimination in medical care settings and opioid pain reliever misuse in a U.S. cohort: 1992 to 2015.
title_fullStr	Racial discrimination in medical care settings and opioid pain reliever misuse in a U.S. cohort: 1992 to 2015.
title_full_unstemmed	Racial discrimination in medical care settings and opioid pain reliever misuse in a U.S. cohort: 1992 to 2015.
title_sort	racial discrimination in medical care settings and opioid pain reliever misuse in a u.s. cohort: 1992 to 2015.
publisher	Public Library of Science (PLoS)
publishDate	2019
url	https://doaj.org/article/47bf98722c1347bbb0846323517fa3ea
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Racial discrimination in medical care settings and opioid pain reliever misuse in a U.S. cohort: 1992 to 2015.

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