Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites

TLDR

Black Americans are systematically undertreated for pain relative to white Americans. The study investigates whether this racial bias is linked to false beliefs about biological differences between blacks and whites, such as the notion that black skin is thicker than white skin. The findings reveal that white laypersons and medical trainees who endorse these false beliefs rate black patients’ pain lower and, in the medical context, make less accurate treatment recommendations, whereas those who do not endorse such beliefs rate pain higher but show no treatment bias, suggesting that these misconceptions contribute to racial disparities in pain assessment and treatment.

Abstract

Black Americans are systematically undertreated for pain relative to white Americans. We examine whether this racial bias is related to false beliefs about biological differences between blacks and whites (e.g., "black people's skin is thicker than white people's skin"). Study 1 documented these beliefs among white laypersons and revealed that participants who more strongly endorsed false beliefs about biological differences reported lower pain ratings for a black (vs. white) target. Study 2 extended these findings to the medical context and found that half of a sample of white medical students and residents endorsed these beliefs. Moreover, participants who endorsed these beliefs rated the black (vs. white) patient's pain as lower and made less accurate treatment recommendations. Participants who did not endorse these beliefs rated the black (vs. white) patient's pain as higher, but showed no bias in treatment recommendations. These findings suggest that individuals with at least some medical training hold and may use false beliefs about biological differences between blacks and whites to inform medical judgments, which may contribute to racial disparities in pain assessment and treatment.