Chronic pain among Asian American children and associations with racial and ethnic discrimination: A nationally...

Chronic pain affects up to 20% of children and adolescents and often persists into adulthood. Asian Americans, one of the fastest-growing U.S. minority groups for those under 18 years old, are underrepresented in chronic pain research despite facing racial and ethnic discrimination-a known risk factor for chronic pain. This study examines the prevalence of chronic pain in Asian American youth and its association with racial discrimination. Cross-sectional analysis of the 2016-2022 National Survey of Children's Health (NSCH) was conducted. Caregivers of children aged 3-17 years old reported if their child had been treated unfairly due to race/ethnicity. Chronic pain was defined as frequent or chronic physical pain over the past 12 months. Rates of chronic pain were compared across racial/ethnic groups, and analyses among Asian Americans (n=13,138) examined associations between discrimination and chronic pain, controlling for sociodemographics, health conditions, and adverse experiences. Asian Americans reported lower chronic pain rates (∼2.8-4.9%) than other racial/ethnic groups (∼5.1-11%, p<0.0001). Among Asian Americans, chronic pain prevalence was higher in those reporting discrimination (12.7% vs. 2.5%, p<0.0001). Risk factors included older age, female gender, low family income, non-U.S. birth, lower parental education, and adverse childhood experiences. In multivariate analyses, racial discrimination was significantly associated with increased chronic pain prevalence (adjusted prevalence ratio: 2.8, 95% CI: 1.5-5.3, p<0.0001). Asian Americans reported lower overall rates of chronic pain relative to other racial and ethnic groups within the United States. Exposure to racial and ethnic discrimination was associated with a significantly increased probability of reporting chronic pain among Asian Americans. PERSPECTIVES: This work addresses gaps in the literature related to the prevalence of pediatric chronic pain in a national sample of Asian American children. It also examines the unique contribution of racial and ethnic discrimination to chronic pain among Asian American children.