Researchers at the University of Florida College of Medicine – Jacksonville are working with personnel from other UF colleges and centers on a study to explore the relationship between social determinants of health and pain outcomes among patients.
The aim is to enroll 150 patients with chronic pain at the Pain Management Center and emergency room on the UF Health Jacksonville campus. Investigators will use a validated tool known as the Area Deprivation Index, or ADI, along with individual patient characteristics, to assess the relationship between socioeconomics and pain via geospatial techniques.
The study, titled “Geospatial Analysis to Predict Pain Outcomes,” is being funded through the UF Research Opportunity Seed Fund, which targets interdisciplinary, faculty-initiated research initiatives with potential for larger extramural support. Partnering UF entities include the Center for Data Solutions, College of Medicine in Gainesville, College of Pharmacy, Pain Research and Intervention Center of Excellence, Precision Medicine Program and the GeoPlan Center.
Using detailed data
Geospatial analysis is the highly detailed gathering, display and manipulation of imagery, GPS info, satellite photography and historical data. The ADI allows for the ranking of neighborhoods by socioeconomic disadvantage, including domains such as income, education, employment and housing quality.
“While existing research demonstrates how socioeconomic disadvantage is linked to issues such as poor pain outcomes, geospatial mapping will provide a more comprehensive picture of what is happening at the neighborhood level for our patients,” said Sophia Sheikh, MD, an assistant professor of emergency medicine at the UF College of Medicine – Jacksonville and the study’s principal investigator. “Additionally, we are exploring the relationship of socioeconomic and environmental factors with biological and genetic changes that may influence a patient's pain experience.”
Chronic pain is a leading cause of disability in the U.S. and is linked to increased health care costs, greater dependency and decreased quality of life. Meanwhile, studies show that living in a socioeconomically disadvantaged area correlates with poor health, increased morbidity and mortality. The study will help identify clusters of patients at risk for poor pain outcomes from chronic pain, including risk for opioid abuse or misuse, thus enabling targeted interventions and prevention strategies.
The researchers’ long-term goal is to create a profile of genetic, psycho-environmental and socio-environmental risk and protective factors that will better identify patients at risk for poor pain outcomes. Such information can aid scientists and health care professionals in predicting poor pain outcomes in the future, ultimately leading to better care for patients living with pain.
“This multidisciplinary team of UF emergency medicine physicians, geospatial analysts and social epidemiologists are all invested in using our expertise to investigate social determinants and chronic pain,” said Jennifer Brailsford, PhD, a sub-investigator of the study and medical scientist at the UF Center for Data Solutions. “Our research will be an important foundation for how the medical field approaches targeted pain treatment and prevention programs.”
Other sub-investigators of the study include Larissa Cavallari, PharmD; Roger Fillingim, PhD; Erik Finlay; Phyllis Hendry, MD; Eugene “Sam” Palmer; and Monika Patel, MD.
A continuing effort
The geospatial analysis award follows a $20,000 grant Patel and Sheikh received in 2019 from the Foundation for Physical Medicine and Rehabilitation to study the intersection of socioeconomics and chronic pain among patients on the UF Health Jacksonville campus. The study, titled “Neighborhood of Pain – Health Disparity Influence on Level of Chronic Pain Interference (HELP),” targeted elderly and lower-income patients with degenerative spine conditions.
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Phyllis L. Hendry, MD, FAAP, FACEP
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