Why Are African American Pain Patients Treated Differently By Doctors?

By Zachary Siegel 04/11/16

A slew of studies has uncovered the disturbing racial bias that some doctors hold about the pain threshold of their patients of color. 

Why Are African American Pain Patients Treated Differently By Doctors?
Courtesy of PNAS/Hoffman et al

In medical settings, African Americans are less likely to receive effective treatment for pain. A new study illuminates why this is the case, and the reasons are startling. 

For the study, researchers at the University of Virginia surveyed medical students and residents—all of whom were white—to see how many believed false and even "fantastical" differences about race in a medical context. Participants responded to prompts such as “blacks have less sensitive nerve endings than whites” or that “black people's blood coagulates more quickly.”

The results demonstrated that half of the students surveyed thought at least one of the inaccurate statements was possibly, probably or definitely true. Furthermore, those who believed such statements to be true also underrated the degree to which black patients felt pain, compared to their white counterparts. This resulted in ill-advised treatment recommendations. 

Kelly Hoffman, a University of Virginia doctoral student who led the study, told the Washington Post she was expecting some endorsement of the fictitious statements regarding racial differences. But she and her team mentioned just how surprised they were at the percentages, which were above what they hypothesized. 

One disturbing example was that of those who participated in the study, 58% held the erroneous belief that "blacks' skin is thicker than whites."

Published in the Proceedings of the National Academy of Sciences, this study sheds light on a disturbing trend in contemporary pain treatment, that whites are more likely than blacks to be prescribed strong painkillers for the same ailments. It comes down to bias. 

A slew of studies support this finding. For instance, a 2000 study of a hospital emergency room in Atlanta found that 74% of white patients with various bone fractures were given painkillers compared to 50% of black patients with bone fractures. 

In another study, which was published last year, black children with appendicitis were found to be less likely to receive pain medication than white children. Yet another study, published in 2007, demonstrates that physicians have the tendency to undervalue the pain experienced by black patients.  

It comes down to a lack of empathy for people who are different, coupled with “unconscious stereotypes” about race, that results in unequal treatment. 

Percentage of white participants endorsing beliefs about biological differences between blacks and whites. (Courtesy of PNAS/Hoffman et al)

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.