Youth experiences with discrimination and the association with multisite pain

Childhood experiences with pain and discrimination can have lasting negative impacts on short- and long-term health outcomes, yet the association between pain and discrimination remains incompletely understood.

This study examined the association between childhood experiences of discrimination and multisite pain in a large longitudinal cohort of 7,979 children aged 9 to 10 years from the Adolescent Brain Cognitive Development Study.

The primary outcome was self-reported multisite pain determined from a body map at year 2 follow-up. Discrimination was assessed at the year 2 follow-up with the Perceived Discrimination Scale (PDS).

The prevalence of multisite pain in the cohort was 13.8%. Children experiencing higher levels of perceived discrimination had increased odds of reporting multisite pain (OR = 2.28, 95% CI 1.9-2.72; P < 0.001). All 4 subtypes of discrimination assessed by the Adolescent Brain Cognitive Development study (weight, sexuality, country of origin, and race/ethnicity) were significant and independent predictors of multisite pain. Children experiencing discrimination based on weight had the highest odds of multisite pain (OR = 3.22, 95% CI 2.40-4.33; P < 0.001). Discrimination was also associated with higher self-reported average pain severity (0.48-point increase for every one-unit increase on the PDS, 95% CI 0.28-0.68; P < 0.001) and interference with daily activities (1.18 times higher for every one-unit increase on the PDS, 95% CI 1.06-1.32; P = 0.004).

These findings suggest that childhood discrimination is associated with multisite pain and greater pain severity and interference. Healthcare providers should consider assessing discrimination experiences in children presenting with pain.