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.racial bias | pain perception | health care disparities | pain treatment A young man goes to the doctor complaining of severe pain in his back. He expects and trusts that a medical expert, his physician, will assess his pain and prescribe the appropriate treatment to reduce his suffering. After all, a primary goal of health care is to reduce pain and suffering. Whether he receives the standard of care that he expects, however, is likely contingent on his race/ethnicity. Prior research suggests that if he is black, then his pain will likely be underestimated and undertreated compared with if he is white (1-10). The present work investigates one potential factor associated with this racial bias. Specifically, in the present research, we provide evidence that white laypeople and medical students and residents believe that the black body is biologically different-and in many cases, stronger-than the white body. Moreover, we provide evidence that these beliefs are associated with racial bias in perceptions of others' pain, which in turn predict accuracy in pain treatment recommendations. The current work, then, addresses an important social factor that may contribute to racial bias in health and health care.Extant research has shown that, relative to white patients, black patients are less likely to be given pain medications and, if given pain medications, they receive lower quantities (1-10). For example, in a retrospective study, Todd et al. (10) found that black patients were significantly less likely than white patients to receive analgesics for extremity fractures in the emergency room (57% vs. 74%), despite having similar self-reports of pain. This disparity in pain treatment is true even among young children. For instance, a study of nearly one million children diagnosed with appendicitis revealed that, relative to white pa...

We investigated whether individual differences in racial bias among white participants predict the recruitment, and potential depletion, of executive attentional resources during contact with black individuals. White individuals completed an unobtrusive measure of racial bias, then interacted with a black individual, and finally completed an ostensibly unrelated Stroop color-naming test. In a separate functional magnetic resonance imaging (fMRI) session, subjects were presented with unfamiliar black male faces, and the activity of brain regions thought to be critical to executive control was assessed. We found that racial bias predicted activity in right dorsolateral prefrontal cortex (DLPFC) in response to black faces. Furthermore, activity in this region predicted Stroop interference after an actual interracial interaction, and it statistically mediated the relation between racial bias and Stroop interference. These results are consistent with a resource depletion account of the temporary executive dysfunction seen in racially biased individuals after interracial contact.

The social psychological literature maintains unequivocally that interracial contact is stressful. Yet research and theory have rarely considered how stress may shape behavior during interracial interactions. To address this empirical and theoretical gap, the authors propose a framework for understanding and predicting behavior during interracial interactions rooted in the stress and coping literature. Specifically, they propose that individuals often appraise interracial interactions as a threat, experience stress, and therefore cope-they antagonize, avoid, freeze, or engage. In other words, the behavioral dynamics of interracial interactions can be understood as initial stress reactions and subsequent coping responses. After articulating the framework and its predictions for behavior during interracial interactions, the authors examine its ability to organize the extant literature on behavioral dynamics during interracial compared with same-race contact. They conclude with a discussion of the implications of the stress and coping framework for improving research and fostering more positive interracial contact.

The present work provides evidence that people assume a priori that Blacks feel less pain than do Whites. It also demonstrates that this bias is rooted in perceptions of status and the privilege (or hardship) status confers, not race per se. Archival data from the National Football League injury reports reveal that, relative to injured White players, injured Black players are deemed more likely to play in a subsequent game, possibly because people assume they feel less pain. Experiments 1–4 show that White and Black Americans–including registered nurses and nursing students–assume that Black people feel less pain than do White people. Finally, Experiments 5 and 6 provide evidence that this bias is rooted in perceptions of status, not race per se. Taken together, these data have important implications for understanding race-related biases and healthcare disparities.

Three studies investigated the veracity of a resource depletion account of the impairment of inhibitory task performance after interracial contact. White individuals engaged in either an interracial or same-race interaction, then completed an ostensibly unrelated Stroop color-naming test. In each study, the self-regulatory demands of the interaction were either increased (Study 1) or decreased (Studies 2 and 3). Results revealed that increasing the self-regulatory demands of an interracial interaction led to greater Stroop interference compared with control, whereas reducing self-regulatory demands led to less Stroop interference. Manipulating self-regulatory demands did not affect Stroop performance after same-race interactions. Taken together, the present studies point to resource depletion as the likely mechanism underlying the impairment of cognitive functioning after interracial dyadic interactions.