Objective Racial and ethnic minorities in the United States report higher levels of both clinical and experimental pain, yet frequently receive inadequate pain treatment. Although these disparities are well documented, their underlying causes remain largely unknown. Evidence from social psychological and health disparities research suggests that clinician–patient racial/ethnic concordance may improve minority patient health outcomes. Yet whether clinician–patient racial/ethnic concordance influences pain remains poorly understood. Methods Medical trainees and community members/undergraduates played the role of “clinicians” and “patients,” respectively, in simulated clinical interactions. All participants identified as non-Hispanic Black/African American, Hispanic white, or non-Hispanic white. Interactions were randomized to be either racially/ethnically concordant or discordant in a 3 (clinician race/ethnicity) × 2 (clinician–patient racial/ethnic concordance) factorial design. Clinicians took the medical history and vital signs of the patient and administered an analogue of a painful medical procedure. Results As predicted, clinician–patient racial/ethnic concordance reduced self-reported and physiological indicators of pain for non-Hispanic Black/African American patients and did not influence pain for non-Hispanic white patients. Contrary to our prediction, concordance was associated with increased pain report in Hispanic white patients. Finally, the influence of concordance on pain-induced physiological arousal was largest for patients who reported prior experience with or current worry about racial/ethnic discrimination. Conclusions Our findings inform our understanding of the sociocultural factors that influence pain within medical contexts and suggest that increasing minority, particularly non-Hispanic Black/African American, physician numbers may help reduce persistent racial/ethnic pain disparities.

While language and culture influence cognition, their role in shaping pain remains understudied. We tested whether language and cultural identification influence pain report among Spanish-English bilinguals. Eighty bilingual Hispanics/Latinos (40 female) experienced painful thermal stimulations, providing pain intensity and unpleasantness ratings, on separate English and Spanish testing days. Participants' skin conductance responses (SCRs) during stimulations served as measures of physiological arousal. Bilingual participants showed larger SCRs and higher pain intensity when speaking the language congruent with their dominant cultural identification. That is, those endorsing more Hispanic cultural identification showed higher pain in Spanish, while US-American-dominant participants demonstrated increased pain in English. Follow-up moderated mediation demonstrated that SCRs mediated language effects on pain ratings for participants endorsing greater Hispanic cultural identification. Together, our results suggest language, cultural associations, and bodily arousal synergistically influence pain evaluations among bilingual people, potentially contributing to well-documented health disparities between Hispanic and non-Hispanic communities.

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Abstract. Cultural priming studies frequently employ non-validated, stereotypical images. Here, we empirically select images to separately evoke two cultural mindsets: Hispanic and US-American. Spanish-English bilinguals identifying as Hispanic/Latino ( N = 149) rated 50 images online for their cultural and emotional evocation. Based on relative cultural identification, cultural “delegate” (strongly US-American, strongly Hispanic, balanced bicultural) subsamples’ ratings were averaged to isolate particularly salient images. Image ratings were compared across respondents’ national origins. Ratings of seven selected pairs of content-matched Hispanic and US-American primes were compared across the full sample. High discrimination across cultural mindsets and positive emotion ratings were maintained regardless of various demographic factors. Thus, we provide empirical justification for incorporating these stimuli, individually or as sets, within cultural priming studies among Hispanic/Latino samples.

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