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Understanding causes, sustained racial disparities in pain

  • July 13, 2020
Edwin Aroke

By Erica Techo

University of Alabama at Birmingham (UAB) School of Nursing Assistant Professor Edwin Aroke, Ph.D., CRNA, has received two one-year grants to continue his research into racial disparities in pain, studying the mechanistic role of epigenetics — and the part of providers’ decision making — in an effort to end the disparities.

“These small grants, a UAB Faculty Development Grant and a UAB Obesity Health Disparities Research Center grant, are incremental steps toward understanding what causes and sustains racial disparities in pain,” Aroke said. “Overall, we are trying to solve the puzzle of racial disparities in pain. I focus on epigenetics because it provides a core mechanism by which environmental exposure affects gene expression. Understanding this biological mechanism is essential for the development of effective treatments.”

Aroke is the primary investigator on a $50,000 grant from the UAB Obesity Health Disparities Research Center, which will focus on the relationship between obesity and pain in African Americans.

“We have observed that more obese patients tend to report more pain, and the pain they report is not limited to weight-bearing areas,” Aroke said. “Using an epigenomic approach, we want to explore the relationship between obesity and pain; we want to examine whether genes that control inflammation are turned on or turned off in persons with obesity and pain.”

Aroke’s co-investigators on the grant include UAB School of Nursing Associate Professor Pamela G. Bowen, Ph.D., CRNP, FNP-BC, BBA, whose research centers on health disparities and obesity in African Americans, and UAB School of Nursing Assistant Professor Bryan Wilbanks, Ph.D., DNP, CRNA, whose program of research includes improving clinical practice and evidence-based guidelines through anesthesia. Focusing his research on African Americans helps fill a gap in knowledge regarding obesity and pain.

“Most of what we know about pain in obesity has been gathered in studies of white patients, but when you look at the racial group differences, African Americans tend to have more obesity and more pain,” Aroke said.

Aroke’s $8,100 Faculty Development Grant steps away from epigenetics to look at another perspective in racial disparities in pain — providers decision-making process. This one-year grant will enable him to collect preliminary data on how CRNAs make pain management decisions.

“CRNAs will watch simulated videos of patients complaining of pain and would decide how much medication to administer,” Aroke said.

Given that CRNAs administer most anesthetics in the United States, this information would inform future studies to improve postoperative pain management.

“It has been a great opportunity being at UAB,” Aroke said. “With adequate funding, I feel like the sky is the limit on growing my program of research and reducing disparities in pain.”