by Allison Danish, MPH
Physicians are twice as likely to underestimate pain in Black patients compared to all other ethnicities combined.
"Beliefs that blacks and whites are fundamentally and biologically different have been prevalent in various forms for centuries. 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.
"In the 19th century, prominent physicians sought to establish the 'physical peculiarities' of blacks that could 'serve to distinguish him from the white man'. Such 'peculiarities' included thicker skulls, less sensitive nervous systems, and diseases inherent in dark skin. Dr. Samuel Cartright, for instance, wrote that blacks bore a 'Negro disease [making them] insensible to pain when subjected to punishment'. Other physicians believed that blacks could tolerate surgical operations with little, if any, pain at all.
"Well into the 20th century, researchers continued to experiment on black people based in part on the assumption that the black body was more resistant to pain and injury. The military covertly tested mustard gas and other chemicals on black soldiers during World War II, and the US Public Health Service, in collaboration with the Tuskegee Institute, studied the progression of untreated syphilis in black men from 1932 to 1972."
These historical beliefs and practices have significant modern day implications for Black people's health, quality of treatment, and access to care. Understanding the past is critical for understanding the path forward.
And ultimately: Black health, Black pain, and Black Lives Matter.
Staton, L.J., et al (2007). When race matters: disagreement in pain perception between patients and their physicians in primary care. J Natl Med Assoc, 99(5), 532-538.
Hoffman, K.M., Trawalter, S., Axt, J.R., & Oliver, M.N. (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci USA, 113(16), 4296-4301.