Got Pain? Racial Bias in Perceptions of Pain

Abstract

In the days of slavery, White people assumed that Black people felt less pain than did White people. This belief was used to justify slavery; it was also used to justify the inhumane treatment of Black men and women in medical research. Today, White Americans continue to believe that Black people feel less pain than do White people although this belief has changed from its historical, explicitly racist form. Racial attitudes do not moderate the bias, suggesting that racial bias in perceptions of others' pain is not rooted (solely) in racial prejudice. Moreover, Black Americans too believe that Black people feel less pain than do White people, suggesting that the bias is no longer grounded in intergroup dynamics. Rather, contemporary forms of this bias stem from assumptions that Black people face more hardship and “thus” can withstand more pain and assumptions that Black people's bodies are not only different but also superhuman. Although this new instantiation of the pain perception bias is decidedly more “benevolent”, it can nonetheless lead to negative outcomes. Here, we consider how racial bias in perceptions of others' pain may affect racial disparities in health care and intergroup relations more generally. We also discuss potential avenues for interventions aimed at preventing this bias among children and reducing this bias among adults.

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

“…This opposite bias perhaps reflects real-world differences, as previous work has shown that black patients tend to report greater pain than do white patients (7,24,42). This opposite bias could also reflect participants' attempt to compensate for known racial disparities (see ref.…”

“…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 (20)(21)(22)(23)(24)(25). In the 19th century, prominent physicians sought to establish the "physical peculiarities" of blacks that could "serve to distinguish him from the white man" (23).…”

“…Third, it investigates whether racial bias in pain perception is related to racial bias in pain management. We focus on white participants given the historical context of black-white relations, particularly in the medical context (20)(21)(22)(23)(24)(25). Analyses for nonwhite participants can be found in the SI Text for the interested reader.…”

“…As in previous work (15), we excluded participants who were not born in the United States or native English speakers, as well as participants who did not complete all of the relevant measures. We also excluded all nonwhite participants, given the historical context of blackwhite relations, particularly in the medical context (20)(21)(22)(23)(24)(25). Our final sample consisted of 92 participants (28% female; M age = 26.70, SD = 8.76).…”

“…Including these participants in our analyses does not change the pattern of results. We again excluded nonwhite participants given the historical context of black-white relations, particularly in the medical context (20)(21)(22)(23)(24)(25). The final sample consisted of 222 participants (first years, n = 63; second years, n = 72; third years, n = 59; residents, n = 28; 48% female; M age = 25.18, SD = 2.66).…”