Pain and Race in Healthcare

In healthcare, there are a multitude of differences between the perception of pain and the treatment that follows, and race. The two main areas of pain and race in healthcare that this blog post will cover is the how different conditions are characterised as having more persistent pain with certain ethnicities (Campbell & Edwards, 2013), as well as the false beliefs and implicit bias that come alongside pain treatment within different ethnicities (Meints, Cortes, Morais & Edwards, 2019).

An example of pain being perceived as greater in certain ethnicities is how people of a black background had reported greater suffering with conditions such as glaucoma, arthritis, AIDS, migraine headaches and more compared to their white counterparts (Campbell & Edwards, 2013). This research found that these conditions that had these more persistent pain complaints with different ethnicities are independent to other potential aggravating factors for certain conditions such as age, sex, socioeconomic status, and more. This highlights how there is a relationship between ethnicity and pain throughout different conditions. Therefore, how can this be supported in the medical field? The solution to this is through the support of the individual patient, and to address their needs based on their perceived pain. However, surveys suggest that patients of an ethnically diverse background felt that they would have received better healthcare if they were of a different ethnicity (Johnson et al, 2004). Therefore, this shows how the perceptions of pain within different conditions amongst ethnicities in healthcare can lead to a negative experience for patients.

Furthermore, the main topic of this blog post is analysing the racial bias in the methods of pain treatment, and how this causes harm to patients. During slavery, the assumption that black people “felt less pain” was used as a justification for their inhumane treatment. Whilst the context has changed nowadays, this belief has developed from its historical form, and this subconscious bias still exists that black people do not feel pain to the degree of people of other ethnicities (Trawalter & Hoffman, 2015). Whilst in a vacuum, this form of discrimination is already hateful, this provides a larger problem in the context of healthcare. This concept of underestimating the pain of black people is supported by a study which found that physicians are twice as likely to underestimate their pain in comparison to all other ethnicities combined (Staton et al, 2007). This shows how this aforementioned implicit bias still exists within healthcare professionals. Therefore, with using these statistics, black people are half as likely to receive the necessary pain medication within a healthcare environment which could lead to further pains from this original issue, as well as provide a sense of distrust between patients and healthcare professionals. Furthermore, alongside the idea that black people do not feel as much pain as white people, black and Hispanic people were also viewed as more likely to require scrutiny for potential drug abuse than white people (Becker et al, 2011). This highlights another barrier to receiving fair pain treatment that people of different ethnicities have, and providing examples of how there is still racial bias that exists within the treatment for pain amongst different ethnicities.

References

Becker, W., Starrels, J., Heo, M., Li, X., Weiner, M., Turner, B. (2011) Racial Differences in Primary Care Opioid Risk Reduction Strategies. Annals of Family Medicine. pp 219-225

Campbell, C., Edwards, R. (2013) Ethnic differences in pain and pain management. Pain Management. pp 219-230

Johnson, R., Saha, S., Arbelaez, J., Beach, MC., Cooper, L. (2004) Racial and ethnic differences in patient perceptions of bias and cultural competence in health care. Journal of General Internal Medicine. pp 101-110

Meints, S., Cortes, A., Morais, C., Edwards, R. (2019) Racial and ethnic differences in the experience and treatment of noncancer pain. Pain Management. pp 317-334

Staton, L., Panda, M., Chen, I., Genao, I., Kurz, J., Pasanen, M., Mechaber, A., Menon, M., O’Rorke, J., Wood, J., Rosenborg, E., Faeslis, C., Carey, T., Calleson, D., Cykert, S. (2007) When race matter: disagreement in pain perception vetween patients and their physicians in primary care. Journal of the National Medical Association. pp 532-538

Trawalter, S., Hoffman, K. (2015). Got Pain? Racial Bias in Perceptions of Pain. Social and Psychology Compass. Volume 9, Issue 3. pp 146-157