physicians believe blacks have thicker skin and can endure more pain
By Frederick H. Lowe
My mother, Ruth Belle Lowe, would soon die from cancer.
I stayed in her hospital room in Tacoma, Washington, my family’s hometown.
She screamed in pain throughout the night. An orderly came and fluffed her pillows but did little else. I don’t remember seeing a doctor or nurse visit her to administer medication to relieve her pain, although I angrily demanded help. The nurses said my mother was on a schedule for pain medication.
The hospital sent my mother home in that condition. My father, Mitchell Lowe, was clearly shaken.
My mother died nearly 30 years ago. Now I may have a clue as to why she was allowed to suffer in her hospital room a few feet away from the nurses’ station before being sent home in pain.
It may not be a complete answer, but it sheds some light.
The answer is included in a report of a study issued by the University of Virginia titled, Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. The study was published in the medical journal Proceedings of the National Academy of Sciences.
The World Health Organization found only 35 percent of racial minority patients suffering from with metastatic or recurrent cancer received appropriate prescriptions established by WHO guidelines compared with 50 percent of nonminority patients.
The racial divide in treating pain
Some white medical residents and medical students believe blacks have thicker skin than whites, therefore; they need less pain medication.
“Black Americans are systematically under treated for pain relative to white Americans,” the study reported. “We examine whether 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).
The report examined two areas in studying this thesis.
Study one documented a belief among white laypersons who falsely believe that black people’s skin is thicker than white skin, therefore; they needed less pain medication. Ninety-two white adults without medical training participated in this part of the study.
Only 35% of racial minorities with metastatic cancer or recurrent cancer received appropriate prescriptions compared with 50 percent of nonminority patients
Study two extended these findings to medical students and medical residents. Half the medical students and residents endorsed the false belief black people had thicker skin than whites; therefore they required less medication to relieve pain.
Moreover, medical students and residents who endorsed these beliefs rated black (vs. white) patients’ pain as lower and made less adequate 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, the report stated. Two hundred and twenty-two white medical students and residents participated in this part of the study.
Medical students and residents rated black patients’ pain as lower and made less adequate 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,” the report stated.
The study noted that research has shown that relative to white and black patients, black patients are less likely to be given pain medications, and if given pain medication, they are given in lower amounts than whites.
This disparity in pain medication also applies to children.
“For instance, a study of nearly one million children diagnosed with appendicitis revealed that, relative to white patients, black patients were less likely to receive any pain medication for moderate pain and were less likely to receive opiods—the appropriate treatment—for severe pain,” the report stated.
The study noted that physicians my not recognize black patients’ pain in the first place; therefore, they cannot treat it.
Centuries of inhumane treatment
“In fact, recent work suggests that racial bias in pain treatment may stem, in part to from racial bias in perceptions of others’ pain,” the report stated. “This research has shown that some people assume that blacks feel less pain than whites.” The report notes that racial beliefs that blacks and whites are biologically different have been prevalent in various forms in this country for centuries.
“In the United States, these beliefs were championed by scientists, physicians and slave owners alike to justify slavery and the inhumane treatment of black men and women in medical research,” the report stated.
U.S. history is rife with examples.
The U.S. Public Health Service, in collaboration with Tuskegee Institute (now University), studied the progression of untreated syphilis in black men from 1932 to 1972.
And employees of Johns Hopkins Hospital in Baltimore kidnapped black people off the streets for medical experiments, according to the book “The Immortal Life of Henrietta Lacks,” by Rebecca Skloot.
Researchers at Johns Hopkins also persuaded Baltimore landlords to rent apartments and houses with high levels of lead content in the paint and water pipes to blacks so researchers could study the effects of lead on the body. Lead poisoning causes permanent brain damage.
During World War 2, black soldiers were used as guinea pigs in mustard gas experiments.
The University of Virginia issued its report on the 30th anniversary of the “Secretary’s Task Force on Black & Minority Health,” which was released in August 1985 by Margaret M. Heckler, U.S. Secretary of Health and Human Services under President Ronald Reagan.
The Heckler report, as it was called, was the first comprehensive documentation of racial disparities in health care. The University Virginia report was received for review on August 18, 2015, and approved on March 1, 2016.