The Relationship Between Sociodemographic, Behavioral, and Clinical Variables and Pain in the Native Hawaiian and Pacific Islander Population

Highly prevalent in the United States, chronic pain (CP) is associated with depression, anxiety, insomnia, and suicide behavior. Racial and ethnic differences in CP have been documented, but Native Hawaiians and Pacific Islanders (NHPI) are frequently grouped with Asians despite different cultural/social experiences. Using the 2014 NHPI National Health Interview Survey, we examined the prevalence of CP and associations with sociodemographic and health correlates. Descriptive statistics were estimated followed by logistic regression modeling CP and negative binomial regression modeling CP count. Our NHPI cohort consisted of 1,334 adults with pain prevalence similar to all U.S. adults. However, the prevalence of depression and anxiety symptoms was significantly higher among NHPI compared with U.S. adults, particularly for anxiety. In regression models, moderate to severe fatigue ranks above other important factors in predicting both CP and CP count, increasing the odds of CP 4.5 times, 95% confidence interval [2.3, 8.9], and the mean count of pain conditions 1.62 times, 95% confidence interval [1.28, 2.04], for each added condition. Depression symptoms were positively associated with only CP, whereas anxiety symptoms were positively associated with only CP count. This first look at CP among NHPI suggests significant differences between U.S. and NHPI adults in associated risk factors, especially fatigue, depression, and anxiety. Although these results may have clinical implications, additional work is needed to address NHPI heterogeneity to understand fully the NHPI CP experience.