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“Ooh, You Got to Holler Sometime:” Pain Meaning and Experiences of Black Older Adults

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Meanings of Pain

Abstract

Throughout the history of the USA, the Black pain experience has been widely ignored and diminished, by media, medicine, and science. Convergent evidence demonstrates that Black adults shoulder a disproportionate burden of chronic pain and related disability. A structural racism lens shows how conditions such as residential segregation, economic deprivation, experiences of discrimination, and inferior access to high-quality medical care contribute to persistent pain in Black adults, worsen its impact, and impede its effective management. In addition to the negative physical consequences of daily pain, the emotional, social, and spiritual distress caused by unmet pain needs can significantly diminish the quality of life. These factors collectively contribute to complex pain meanings that center around dependence and defeat and are countered through social engagement, spiritual coping, and meaningful activity. Consequently, despite reporting moderate to severe daily pain and an increased frequency of catastrophizing—that is, negative emotional responses to pain and perceived exaggeration—Black older adults often report high levels of adaptive coping as evidenced by continued engagement in activities. The following chapter examines the meaning of pain for Black older adults both within and outside of the medical establishment and in the context of implicit racial bias. The authors examine challenges of effective assessment and treatment, and identify strategies Black older adults engage in to effectively cope with pain and prevent what many fear—becoming dependent on others. Finally, we highlight the need for culturally responsive pain management interventions to effectively address the complex meanings ascribed to pain by Black older adults, including the need for accessible care that is developed in close collaboration with community members to build on existing strengths and resources. Clinical Implications: Culturally responsive care is critical for optimal pain management. This self-reflective practice recognizes the role of bias in care delivery and urges clinicians to empower diverse patients to acknowledge important values, beliefs, and practices related to pain management, and integrate them as appropriate into their treatment plans.

I have pain in my leg. I put it to be arthritis. It hurt, but I try to work it over, and I take aspirins. Then [I] have a lot of cramps and it is so painful. Ooh, you got to holler sometime. It takes awhile to go away, and when it grabs you, it holds you. All you can do is just walk and scream before it go away. It goes away, but then that is painful. ~Jane [All participant names have been changed to protect anonymity (Robinson-Lane 2015)]

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Notes

  1. 1.

    Brown (1855, pp. 47–48).

  2. 2.

    Robinson-Lane (2015). All participant names have been changed to protect anonymity. The participants have given their consent to the publication of their stories.

  3. 3.

    Robinson-Lane (2015). All participant names have been changed to protect anonymity. The participants have given their consent to the publication of their stories.

  4. 4.

    Numbers 14:8.

  5. 5.

    Robinson-Lane (2015). All participant names have been changed to protect anonymity. The participants have given their consent to the publication of their stories.

  6. 6.

    Robinson-Lane (2015). All participant names have been changed to protect anonymity. The participants have given their consent to the publication of their stories.

  7. 7.

    Marijuana use is legal in the state where the study took place.

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Authors and Affiliations

  1. University of Michigan School of Nursing, Ann Arbor, MI, USA

    Sheria G. Robinson-Lane

  2. Morsani School of Medicine, University of South Florida, Tampa, FL, USA

    Tanisha G. Hill-Jarrett

  3. School of Public Health, University of Michigan, Ann Arbor, MI, USA

    Mary R. Janevic

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  1. Sheria G. Robinson-Lane
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  2. Tanisha G. Hill-Jarrett
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  3. Mary R. Janevic
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Correspondence to Sheria G. Robinson-Lane .

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Editors and Affiliations

  1. Department of Philosophy and Gender Studies, School of Humanities, University of Tasmania, Hobart, TAS, Australia

    Simon van Rysewyk

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Robinson-Lane, S.G., Hill-Jarrett, T.G., Janevic, M.R. (2022). “Ooh, You Got to Holler Sometime:” Pain Meaning and Experiences of Black Older Adults. In: van Rysewyk, S. (eds) Meanings of Pain. Springer, Cham. https://doi.org/10.1007/978-3-030-95825-1_4

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