Chronic pain and hazardous drinking among black adults through a minority stress lens: The role of daily microaggressions.

Abstract

Hazardous drinking and chronic pain are highly prevalent and frequently co-occurring health conditions that disproportionately impact Black communities in the United States. Racial microaggressions (i.e., everyday verbal or nonverbal slights that demean individuals based on race) may be associated with both pain and alcohol use among Black adults with chronic pain. This study examined associations between daily racial microaggressions and momentary pain and alcohol use using Ecological Momentary Assessment (EMA) methodology. Participants were 107 Black adults (31.8% female; M_age = 28.10, SD = 4.05; age range = 22-46) with self-reported chronic pain and hazardous drinking. Multilevel models revealed significant positive within-person associations between racial microaggressions and pain interference, pain severity, alcohol craving, and alcohol consumption, as well as significant positive between-person associations for alcohol consumption. Additionally, a dose-response pattern emerged such that experiencing a greater number of microaggressions was associated with higher pain severity, pain interference, and alcohol craving at the within-person level, and higher pain severity, pain interference, and alcohol consumption at the between-person level. These findings suggest that racial microaggressions are associated with both pain and alcohol use in this population. Interventions that acknowledge and address the health impact of racism-related experiences may be important for improving pain-related and alcohol outcomes and reducing health disparities among Black adults with chronic pain.