Could there be racial bias in your prescription for pain?

False beliefs about biological differences between blacks and whites lead to disparities in medical assessment and treatment according to a study recently published in Proceedings of the National Academy of Sciences.   The study examined racial bias in perception of others’ pain among white laypeople (group 1) and white medical students/residents (group 2) as well as the extent to an number of false beliefs were endorsed, including:

• “blacks age more slowly than whites”
• “blacks’ nerve endings are less sensitive than whites’”
• “blacks’ skin is thicker than whites’”
• “blacks are more fertile than whites”

In both groups, participants who held false beliefs rated black (vs. white) patients’ pain as lower.  Among medical students and residents, although percentages holding these beliefs were lower than among laypeople (50% vs. 75%), they were still quite high, and this perception led to bias in treatment recommendations.

Historically, these beliefs were used to justify slavery and the mistreatment of blacks in medical research such as the Tuskegee Syphilis Experiment.  Today, they more likely stem from unconscious bias rather than overt racism.  Perhaps they reflect greater empathy toward white patients (ingroup favoritism) or perception of whites’ frailty.  Whether similar beliefs are held by practicing physicians of both races is unknown.  However, the findings in this study underscore the importance of examining, exposing and rectifying racial disparities in healthcare at all levels.

Read the original publication: www.pnas.org/cgi/doi/10.1073/pnas.1516047113

 

                                                                                                                                Judith Wolf, MD

                                                                                                                                Associate Director, WHEP