Different Races Feel Pain Differently

Posting Date: 10/01/2003

Green and her colleagues also focus on research that has examined how communication between patients and health care providers, and the social context of their interaction, can influence pain diagnosis and treatment.

They also cite numerous studies showing that African-Americans and members of other racial and ethnic minorities are consistently under-treated for pain across a range of conditions, from cancer and chest pain to post-surgical and chronic lower-back pain.

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Access to pain care and pain medications can also vary by race and ethnicity, the authors find. They note findings that pharmacies in neighborhoods with large minority populations tend not to carry narcotic pain medicines such as morphine.

?Physician prescribing patterns, as well as patients? own attitudes and beliefs regarding pain, and socioeconomic factors, may all contribute to racial and ethnic differences in pain management,? writes co-author Raymond Tait, Ph.D., of the St. Louis University School of Medicine. ?But all of these issues related to health care delivery are yet to be adequately explored.?

In fact, says Green, the review of the literature on race, ethnicity and pain only showed the authors how much more there is to find out on this topic.

For instance, much more research is needed on how cultural beliefs, as well as patient-level decision making and preferences, influence the pain-related behavior of patients from racial and ethnic minorities. Further studies should be done, the authors say, to correlate experimental findings on pain perception and tolerance with clinical pain, especially where there are differences between racial and ethnic groups.

Even the tools that doctors and nurses use to ask patients how severe their pain is need to be examined for cultural and linguistic sensitivity. Better data on disparities in various health care settings, and in different insurance and legal contexts, should be gathered. And more studies are needed to understand how stereotypes and other sources of bias can color the interaction between health care providers and patients, and what strategies might counteract these effects.