White Patients Taken More Seriously by Medical Professionals.

Racial and ethnic disparities in health care continue to be a significant challenge in Canada, the US, and the UK, as confirmed by multiple reports from provincial and national medical watchdogs in these countries. These reports highlight the uneven impact of the COVID-19 pandemic on people of color, illustrating the longstanding structural and systemic inequities rooted in historical and ongoing race-based discrimination within our public service institutions.

A separate report released by the Ontario Health Coalition (OHC) in June further supports these findings, stating that the level of pain relief a person receives in provincial clinics and hospitals often depends on their skin tone.

The report also quoted Dr. Amit Arya of Toronto, who pointed out clear anti-Black bias in pain management. He stated that: 

–            About half of white medical students and residents endorsed incorrect, racist beliefs about Black patients (e.g., that Black skin is thicker than white skin). This bias resulted in lower assessments of Black patients’ pain and subsequent undertreatment.

–            A 20-year meta-analysis and systematic review of medical diagnoses across the province revealed that Black patients were 22% less likely than white patients to receive any pain medication.

–            Black patients with painful injuries, such as fractures, burns, or penetrating injuries, were less likely to receive appropriate pain management before being hospitalized.

–            Ethnic minority patients with metastatic cancer were three times less likely to receive adequate pain management.

A 2024 study from the University of Delaware found that participants were slower to recognize pain in Black boys compared to white boys when presented with computer-generated images of children’s faces. This delay is significant because when healthcare providers fail to identify their patients’ pain, they are less likely to recommend appropriate treatment.

This issue is not confined to a specific department or stage of life. It can affect care at all levels, from childhood injuries to childbirth, chronic illness, and the final months of cancer treatment.

Furthermore, the problem is not limited to Black individuals alone; it impacts other people of color as well. Research from both the US and Canada indicates a persistent gap in how pain is recognized and treated for patients from nearly every minority ethnic background.

When Early Warning Signs Are Missed Because the Patient Is Not White.

A 2020 research project conducted by Children’s National Hospital revealed a significant disparity in emergency rooms: children from minority ethnic groups with fractures were less likely to receive opioid pain relief, even when injury severity and pain levels were considered.

Dr. Monika Goyal, one of the authors of the research paper, noted, “When looking at optimal pain reduction, minority children were more likely to be discharged home in significant pain compared to their white counterparts.”

Similar assumptions can also arise during childbirth, where minutes can mean the difference between life and death. Evidence collected by The Guardian from a UK maternity survey included first-person accounts of Black women feeling stereotyped as being able to tolerate more pain, while Asian women were described in a manner that suggested they were demanding or unable to cope.

One female patient remarked, “I feel like, for us Black ladies, they (medical staff) assume we can handle the pain, even when we are complaining about being in pain.”

This perception is supported by a study from Boston University, which found that ethnic minorities in the US were much less likely than white patients to receive opioid medication during pain-related emergency visits. For patients with sickle cell disease, the Sickle Cell Society has reported delays, disbelief, and failures to meet pain-relief standards during severe crises.

This issue persists beyond emergency rooms. Research published in various medical journals from the U.S., Canada, and the UK has shown that non-white patients with urgent medical issues, such as chronic lower back pain, often struggle to convince doctors of the severity of their pain. Additionally, Black and Asian patients with Parkinson’s disease are less likely than white patients to receive adequate pain relief.

The critical nature of this issue is underscored when considering that appropriate pain control medication can significantly impact a patient’s quality of life in their final months. Researchers at the University of Hull discovered that cancer patients from Black, South Asian, mixed, and other ethnic backgrounds received fewer opioid prescriptions and lower doses than their white counterparts.

Jonathan Koffman, a professor of palliative care at the University of Hull and the study’s lead researcher, stated, “Adequate pain relief is a human right.”

Findings from multiple surveys and studies indicate that the unequal treatment of pain is not an isolated issue but a recurring risk across various healthcare systems in the West.

*****