Is Black Pain Treated Less?

man holding head in pain( — Ask anyone what their top health complaints are, and guaranteed, pain will probably be pretty high on the list. And whether you’re black or white, we all hurt the same way, right?

Pretty much – but according to studies, how our pain is treated sometimes varies greatly by the color of our skin.

Turns out, Blacks are more likely than whites to deal with untreated pain. Also, they’re less likely to get adequate care for that pain. And minority patients who don’t get proper pain treatment early on are likely to suffer depression and post-traumatic stress disorder down the road, says Dr. Carmen Green, a pain specialist and professor of anesthesiology at the University of Michigan.

Researchers don’t know whether the pain imbalance is due to racial bias, cultural differences, physiological variances, or a combination of factors, but they do know one thing: Pain is not colorblind.

A recent study by Green of 200 chronic pain patients in the University of Michigan health system found that black patients were prescribed fewer pain medications than whites, and that women were given weaker pain medications than men were given. The research published in the Journal of Pain showed that, on average, a minority pain patient would be prescribed 1.8 pain medications compared to 2.6 drugs for non-minority sufferers.

And once Blacks do get a prescription, they have a harder time getting it filled, Green found in an earlier study, also in the Journal of Pain. Only 54 percent of pharmacies in minority neighborhoods had the most common painkillers in stock; in majority-white neighborhoods, 87 percent of pharmacies did.

Green’s studies add to two decades’ worth of research that shows even when pain is indisputable, such as in late-stage cancer and with broken bones, minorities get less help for their suffering.

Chronic Pain & A Lack of Help

That means a lot of unnecessary pain for people like Deborah Chenault-Green (no relation to Dr. Green), a black woman who suffered through seven years of intense pain before finally being diagnosed with herniated discs in her back and neck, as well as multiple sclerosis.

Chenault-Green, now 55, saw countless doctors at inner-city hospitals in her hometown of Detroit, but all they offered her were over-the-counter pain pills. She felt like the doctors weren’t taking her pain seriously — or thought she faking just to get narcotics.

“I can kind of understand where they’re coming from because they do get a lot of people who are looking for pain pills, but they kind of blanket everybody,” Chenault-Green said. “For seven years I went through doctors looking at me sideways and saying ‘Here’s a prescription for Motrin.’”

“I went through depression, I went through thoughts of suicide,” Chenault-Green said. “I thought, these are the doctors, so maybe I am crazy, maybe something is wrong with me.”

Things finally changed for Chenault-Green when she went to a doctor in the suburbs whom she’d seen years before. He heard her symptoms and immediately sent her to a neurologist, who ordered a CT scan and MRI, which identified the herniated discs in her back and neck (for which she had surgery in 2002). Now she’s living mostly pain-free.

Racial disparities exist in all areas of health care. One reason pain is different is that there’s no test for it; the experience of pain is subjective, and the process of identifying and treating pain relies totally on the interaction between patient and doctor.

The rushed pace of modern health care may be partly to blame, said Nomita Sonty, assistant professor of anesthesiology and psychiatry at Columbia University and leader of the American Pain Society’s working group on disparities.

“With the emphasis being on getting patients in and out of clinics quickly, practitioners do not have the time to spend with those who may need just a little longer to be understood due to language, cultural and other barriers,” Sonty said.

Many doctors don’t get great training on how to identify and treat chronic pain, much less how to address racial disparities in practice, said Green, the pain specialist and University of Michigan professor.

“From a research standpoint we are probably 40 to 50 years behind in pain research” compared to other areas, Green said. “We need to address pain in a very different way.”

Don’t Give Up

Green said the best thing that any pain patient can do, regardless of race, is to keep searching until they find a doctor who will listen and take their pain seriously.

“People need to realize the importance of pain,” Green said. “It saps you of your energy, your mood, your time with family and friends. But there are things that we can do. There are people who get their lives back.”

One of those people is Chenault-Green, the singer and actress is active in her community and currently directing a play at the Wayne State Arts Theater — something she could not have dreamed of a few years ago.

“There has been some momentum in the direction of decreasing disparities in health care, but we still have a long ways to go,” Sonty said. “We need to establish a national agenda for addressing pain disparities.”


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