It is well established that Black Americans report more severe chronic low back pain and greater related disability than white Americans. What has been harder to demonstrate is how that difference is produced.
A 2026 study in The Journal of Pain, co-authored by PRICE-affiliated researcher Burel Goodin with colleagues led by Edwin Aroke, took that question on directly.
What they did. The team used a cross-sectional serial mediation analysis — a statistical approach designed to test not merely whether two things are associated, but whether a proposed chain of intermediate steps accounts for the link. They examined both structural racism (measured at the level of the environments people live in) and individualized racism (discrimination experienced personally) as steps in the pathway to racial disparities in chronic low back pain.
What they found. The disparities were mediated through those pathways. Racism, at both the structural and individual level, helped account for the observed differences in chronic low back pain.
Why it matters. Disparities research often stops at documenting that a gap exists. That is necessary, and it is not sufficient — a documented gap invites the wrong explanations as readily as the right ones, and biological explanations have historically filled the vacuum.
Specifying a mechanism does something different. It says: this gap runs through these conditions, and conditions are the kind of thing that can be changed.
Note the design limits: this is cross-sectional, so it establishes mediation within a model rather than causation over time. The authors are clear about that. It is a serious step in a line of work that needs many more.
What we study:
- Pain and Aging
- Chronic Pain Risk Factors
- Pain and the Brain
- Musculoskeletal Pain
- Pain and Exercise
- Non-Medical Treatment of Pain
Prefer to talk to a person? Call 352-273-5967 or email PRICE-CTSI@ufl.edu.
UF Study ID IRB201400126
References
- Aroke EN, Freij KW, Agbor FBAT, et al., Goodin BR. Structural and individualized racism drives racial disparities in chronic low back pain: A cross-sectional serial mediation analysis. J Pain. 2026 Aug;45:106351. https://doi.org/10.1016/j.jpain.2026.106351