An Exploration of Racial Bias in Medical Students' Pain Perceptions and Treatment Decisions

Abstract

Opening Paragraph|Health disparities among various racial and ethnic groups are prevalent in the United States, in part because racial and ethnic minorities often receive substandard medical treatment compared to White patients (for a general review, see Smedley et al.). One such disparity is in the treatment of pain for Black and White patients. The experience of pain is a major determinant of one's quality of life and effectively treating pain can substantially improve that quality of life. Research has consistently shown, however, that pain assessment and pain treatment are often poorer for racial and ethnic minorities in comparison to non-Hispanic Whites (for general reviews of this area of research, see Cintron and Morrison, as well as Green et al.). For example, in a retrospective study of pain treatments for 99,903 U.S. veterans, Black patients were significantly less likely to receive a prescription for opioids than were White patients. Disparities in pain perception and treatment are found across all medical settings, such as postoperative care and emergency medicine, as well as across various types of pain associated with both acute and chronic illnesses. To make matters worse, there is evidence that minority groups actually have a lower pain threshold, lower pain tolerance, and higher pain ratings than White people (for a general review of this research, see Rahim-Williams et al. and Kim et al.). Thus, members of racial minority groups appear to suffer pain more severely yet are treated for pain less aggressively.