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Are we racist in healthcare? Here’s some evidence about racial bias in pain management (THREAD):
#medtwitter #BlackLivesMatter
#medtwitter #BlackLivesMatter
1/ A 20 year meta-analysis and systematic review revealed black patients were 22% less likely than white patients to receive any pain medication. https://pubmed.ncbi.nlm.nih.gov/22239747/
2/ Black patients with painful injuries such as fractures, burns or penetrating injuries were less likely to receive pre-hospital pain management. https://pubmed.ncbi.nlm.nih.gov/28956669/
3/ Ethnic minority patients with metastatic cancer were three times less likely to receive adequate pain management. https://www.nejm.org/doi/full/10.1056/NEJM199403033300902
4/ About half of white medical students & residents endorsed incorrect racist beliefs about black patients (e.g. black skin is thicker than white skin). This led to lower rating of black patients’ pain and undertreatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483/
5/ Historically, violent and cruel “experiments” were done to prove racist beliefs that differences between black & white people were more than cultural- rather black people were biologically different, and had thicker skin. https://www.nytimes.com/interactive/2019/08/14/magazine/racial-differences-doctors.html
6/ Nowadays, biological racism has become less socially acceptable. It has largely been replaced by implicit bias- thoughts & feelings outside of conscious awareness, which directly affect clinical decision making. https://www.acc.org/latest-in-cardiology/articles/2020/01/01/24/42/cover-story-implicit-bias-recognizing-the-unconscious-barriers-to-quality-care-and-diversity-in-medicine
7/ Mandatory education about implicit bias & structural racism is needed for all health workers. Our institutions need to implement and follow-through with anti-racism policies. And we must collect race based data to measure health quality and equity. (END)
