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The impact of structural racism and discrimination on chronic pain in Black or African American older adults: Biopsychosocial mechanisms

Award Number: R01AG081479
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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PROJECT SUMMARY/ABSTRACT In the United States, Black individuals are the group most affected by interpersonal discrimination and struc- tural racism and older Black adults experience a disproportionate burden of chronic-pain and related disability. Accumulating evidence suggests both interpersonal discrimination and structural racism may increase the like- lihood of developing chronic pain and worsen chronic pain outcomes. The psychosocial and neurobiological mechanisms through which structural racism and discrimination adversely affect chronic pain-related out- comes, whether these pathways differ from one another, and what factors may protect against these deleteri- ous effects, remain largely unknown. Understanding these mechanisms is critical to identifying modifiable fac- tors that may serve as actionable intervention targets. Our central hypothesis is that structural racism (racial residential segregation and neighborhood socioeconomic disadvantage) and interpersonal discrimination (di- rect and vicarious) will adversely impact chronic pain-related outcomes via different psychosocial and neurobi- ological pathways. The rationale for this project is that structural racism and discrimination directly impact re- ciprocally interactive biological and psychosocial processes, promoting more rapid progression of musculoskel- etal pain and pain-related disability among Black or African American older adults. The central hypothesis will be tested by three specific aims: 1) Characterize the independent and combined impact of structural racism and discrimination on chronic pain-related outcomes; 2) Test hypothesized pathways of psychosocial and bio- logical mediators whereby structural racism and discrimination influence chronic pain-related outcomes; and 3) Identify resilience factors that may protect against the adverse effects of structural racism and discrimination on pain-related outcomes by either reducing the effects of racism/discrimination on psychosocial stressors, bio- logical mechanisms, or both. Under the first aim, structural racism will be measured using racial residential segregation (neighborhood-level Getis-Ord Gi* statistic) and neighborhood socioeconomic disadvantage (Area Deprivation Index). Experiences of discrimination will include both perceived individual discrimination and vi- carious racism. The research proposed in this application is innovative, because it investigates the individual and combined effects of structural racism and discrimination, examines multiple biopsychosocial mechanisms, and measures individual and community resilience. The proposed research is significant because it is ex- pected to improve understanding of the mechanisms whereby structural racism and discrimination impact mar- ginalized persons with chronic pain. Ultimately, this knowledge has the potential to inform multi-level interven- tions to enhance pain outcomes in racialized and underserved peoples.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $673,416 )
2024	2024	UNIVERSITY OF FLORIDA	1523 UNION RD RM 207	GAINESVILLE	FL	32611	ALACHUA	USA	Aging Research	000	2	1/18/2024	NON-COMPETING CONTINUATION	$673,416
														Subtotal = $673,416

Issue Date FY: 2023 ( Subtotal = $775,704 )
2023	2023	UNIVERSITY OF FLORIDA	1523 UNION RD RM 207	GAINESVILLE	FL	32611	ALACHUA	USA	Aging Research	000	1	3/24/2023	NEW	$775,704
														Subtotal = $775,704

Grand Total All Awards = $1,449,120

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The impact of structural racism and discrimination on chronic pain in Black or African American older adults: Biopsychosocial mechanisms

Award Number: R01AG081479

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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