Physicians were more likely to underestimate the pain of black patients (47%) relative to nonblack patients (33.5%). ( 14), for instance, patients were asked to report how much pain they were experiencing, and physicians were asked to rate how much pain they thought the patients were experiencing. This research has shown that people assume a priori that blacks feel less pain than do whites ( 11 – 17). In fact, recent work suggests that racial bias in pain treatment may stem, in part, from racial bias in perceptions of others’ pain. The second possibility is that physicians do not recognize black patients’ pain in the first place, and thus cannot treat it. The first possibility is that physicians recognize black patients’ pain, but do not to treat it, perhaps due to concerns about noncompliance or access to health care ( 7, 8). For example, a study examining pain management among patients with metastatic or recurrent cancer found that only 35% of racial minority patients received the appropriate prescriptions-as established by the World Health Organization guidelines-compared with 50% of nonminority patients ( 4).īroadly speaking, there are two potential ways by which racial disparities in pain management could arise. Indeed, there is evidence that overprescription is an issue, but there is also clear evidence that the underprescription of pain medications for black patients is a real, documented phenomenon ( 1, 4). These disparities in pain treatment could reflect an overprescription of medications for white patients, underprescription of medications for black patients, or, more likely, both. For instance, a study of nearly one million children diagnosed with appendicitis revealed that, relative to white patients, black patients were less likely to receive any pain medication for moderate pain and were less likely to receive opioids-the appropriate treatment-for severe pain ( 6). This disparity in pain treatment is true even among young children. 74%), despite having similar self-reports of pain. ( 10) found that black patients were significantly less likely than white patients to receive analgesics for extremity fractures in the emergency room (57% vs. For example, in a retrospective study, Todd et al. The current work, then, addresses an important social factor that may contribute to racial bias in health and health care.Įxtant research has shown that, relative to white patients, black patients are less likely to be given pain medications and, if given pain medications, they receive lower quantities ( 1 – 10). Moreover, we provide evidence that these beliefs are associated with racial bias in perceptions of others’ pain, which in turn predict accuracy in pain treatment recommendations. Specifically, in the present research, we provide evidence that white laypeople and medical students and residents believe that the black body is biologically different-and in many cases, stronger-than the white body. The present work investigates one potential factor associated with this racial bias. Prior research suggests that if he is black, then his pain will likely be underestimated and undertreated compared with if he is white ( 1 – 10). Whether he receives the standard of care that he expects, however, is likely contingent on his race/ethnicity. After all, a primary goal of health care is to reduce pain and suffering. He expects and trusts that a medical expert, his physician, will assess his pain and prescribe the appropriate treatment to reduce his suffering. These findings suggest that individuals with at least some medical training hold and may use false beliefs about biological differences between blacks and whites to inform medical judgments, which may contribute to racial disparities in pain assessment and treatment.Ī young man goes to the doctor complaining of severe pain in his back. white) patient’s pain as higher, but showed no bias in treatment recommendations. Participants who did not endorse these beliefs rated the black (vs. white) patient’s pain as lower and made less accurate treatment recommendations. Moreover, participants who endorsed these beliefs rated the black (vs. Study 2 extended these findings to the medical context and found that half of a sample of white medical students and residents endorsed these beliefs. Study 1 documented these beliefs among white laypersons and revealed that participants who more strongly endorsed false beliefs about biological differences reported lower pain ratings for a black (vs.
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BLACK AND WHITE 1 STAR RATING SKIN
We examine whether this racial bias is related to false beliefs about biological differences between blacks and whites (e.g., “black people’s skin is thicker than white people’s skin”). Black Americans are systematically undertreated for pain relative to white Americans.