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Race Differences in Resilience Among Older Adults with Chronic Low Back Pain

Authors Morais CA, Fullwood D, Palit S, Fillingim RB, Robinson ME, Bartley EJ

Received 20 November 2020

Accepted for publication 3 February 2021

Published 9 March 2021 Volume 2021:14 Pages 653—663

DOI https://doi.org/10.2147/JPR.S293119

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Jonathan Greenberg


Calia A Morais,1 Dottington Fullwood,2 Shreela Palit,1 Roger B Fillingim,1 Michael E Robinson,3 Emily J Bartley1

1Department of Community Dentistry and Behavioral Sciences, University of Florida, Gainesville, FL, USA; 2Institute on Aging, Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA; 3Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA

Correspondence: Calia A Morais
Department of Community Dentistry and Behavioral Sciences, University of Florida, 2004 Mowry Road, PO Box 100242, Gainesville, FL, 32610‑0404, USA
Tel +1 352-294-8881
Email [email protected]

Introduction: Racial minorities are disproportionally affected by pain. Compared to non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs) report higher pain intensity, greater pain-related disability, and higher levels of mood disturbance. While risk factors contribute to these disparities, little is known regarding how sources of resilience influence these differences, despite the growing body of research supporting the protective role of resilience in pain and disability among older adults with chronic pain. The current study examined the association between psychological resilience and pain, and the moderating role of race across these relationships in older adults with chronic low back pain (cLBP).
Methods: This is a secondary analysis of the Adaptability and Resilience in Aging Adults (ARIAA). Participants completed measures of resilience (ie, gratitude, trait resilience, emotional support), as well as a performance-based measure assessing lower-extremity function and movement-evoked pain.
Results: There were 45 participants that identified as non-Hispanic White (NHW) and 15 participants that identified as non-Hispanic Black (NHB). Race was a significant correlate of pain outcomes with NHBs reporting greater movement-evoked pain (r = 0.27) than NHWs. After controlling for relevant sociodemographic characteristics, measures of movement-evoked pain were similar across both racial groups, F (1, 48) = 0.31, p = 0.57. Moderation analyses revealed that higher levels of gratitude (b = − 1.23, p = 0.02) and trait resilience (b = − 10.99, p = 0.02) were protective against movement-evoked pain in NHWs. In contrast, higher levels of gratitude were associated with lower functional performance in NHBs (b = − 0.13, p =0.02).
Discussion: These findings highlight racial differences in the relationship between resilience and pain-related outcomes among older adults with cLBP. Future studies should examine the potential benefits of targeted interventions that improve resilience and ameliorate pain disparities among racial minorities.

Keywords: racial differences, pain disparities, resilience, gratitude, older adults

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