Physical pain among urban Native American emerging adults: Socio-cultural risk and protective factors.

ABSTRACT

OBJECTIVE: American Indian/Alaska Native (AI/AN) people have high rates of physical pain. Pain is understudied in urban-dwelling, AI/AN emerging adults, a group with unique socio-cultural risk and protective factors. We explore associations between socioeconomic disadvantage, additional socio-cultural factors, and pain among urban AI/AN emerging adults. METHODS: AI/AN participants aged 18-25 (N = 417) were recruited via social media. Regression models tested associations between socioeconomic disadvantage (income and ability to afford healthcare) and pain as well as additional socio-cultural factors (discrimination, historical loss, cultural pride and belonging, visiting tribal lands) and pain. Multi-group regression models tested whether associations between socio-cultural factors and pain differed between participants who were socioeconomically disadvantaged and those who were less disadvantaged. RESULTS: In the full sample, lower income (b = 1.00 - 1.48, p < .05), inability to afford healthcare (b = 1.00, p = .011), discrimination (b = 0.12, p = .001), and historical loss (b = 0.24, p = .006) were positively associated with pain, whereas visiting tribal lands was negatively associated with pain (b = -0.86 - -0.42, p < .05). In the multi-group model, visiting tribal lands 31+ days was negatively associated with pain only among the less socioeconomically disadvantaged group (b = -1.48, p < .001). CONCLUSIONS: Socioeconomic disadvantage may, in part, drive pain disparities among AI/AN emerging adults and act as a barrier to benefitting from visiting tribal lands. Results support a biopsychosocial approach to targeting pain in this population, including addressing socioeconomic challenges and developing culturally informed, strengths-based interventions.