Breaking your leg is objectively painful. But the treatment you get from your doctor can often depend on whether you’re black or white.
In new research published in Proceedings of the National Academy of Sciences, researchers at the University of Virginia found that many white laypeople, medical students, and residents hold false assumptions about how black people feel pain, believing that black patients are more resistant to it. Those beliefs can be brought into the profession and lead to inadequate treatment, the study points out. The findings are part of a racial bias problem that researchers have sought to resolve for decades, but to no avail.
"There are huge disparities in how blacks and whites are treated by the medical community."
"We've known for a long time that there are huge disparities in how blacks and whites are assessed and treated by the medical community," Kelly Hoffman, a psychologist at the University of Virginia, said in the study’s official release. "Our study provides some insight to what might contribute to this — false beliefs about biological differences between blacks and whites."
Hoffman and her fellow researchers conducted two studies to determine how pervasive racial biases are. For the first study, the team recruited 121 laypeople, 92 of whom were white and born in the United States. Researchers found that 72 percent of the white people in the sample endorsed at least one false belief about how black people experience pain. For example, they thought black people have thicker skin than their white counterparts. The second study expands on the first: the team collected responses from 418 medical students and residents, 222 of whom were white. About 50 percent of the white respondents showed at least one false belief about black patients’ pain symptoms.
Crucially, the med students and residents who espoused false beliefs were more likely to give lower pain ratings for black patients suffering from injuries like broken legs or kidney stones. Their treatment recommendations were lower than those offered by the World Health Organization. The unprejudiced respondents didn’t deviate from the WHO’s recommendations.
Race is a fiction
It’s important to note here that false beliefs stem from the idea that race is biologically fixed. That’s not true. Race is a fiction. It’s true that pain and disease affect certain groups in greater numbers than others, but they by no means affect those groups exclusively. And race certainly doesn’t prevent individuals from feeling pain or needing appropriate pain management. In other words, while pain itself might be hard to pin down from person to person, systemic racism isn’t.
"These beliefs have been around for a long time in our history," said Hoffman. "They were once used to justify slavery and the inhumane treatment of black people in medicine."
This rampant unconscious bias in medicine can lead to death. A recent study published in The American Journal of Gastroenterology found that black patients are 19 percent more likely to die from common gastrointestinal problems than white patients, but fare better when treated by black doctors. However, systemic issues also create a barrier for black medical students. According to Marc Nivet, chief diversity officer for the Association of American Medical Colleges, students of color are routinely left behind by the education system, making them ill-equipped for medical school as early as third grade.
Black patients fare better with black doctors, but there aren't enough
"We don't have enough minority students taking the right classes early on and becoming successful in those classes early on to make successful applicants to any health professional school," Nivet told Vice News.
Back in 1985, President Reagan’s Health and Human Services Secretary Margaret Heckler formed a task force to investigate the kind of care black and white people received by doctors. The resulting Heckler Report exposed the rampant inequalities in health care at the time. Thirty years later, those inequalities still persist. It’s foolish to pretend medical science is immune to social biases. With new light shining on the problem, hopefully more work can be done to ensure all people are treated equally, regardless of the kind of pain they’re in.