NCPA - National Center for Policy Analysis

Racial Disparity In Pain Relief?

December 29, 1999

It appears there is a racial and/or ethnic disparity in the way patients with broken bones are treated in emergency rooms -- with blacks and Hispanics less likely to receive pain relievers than white patients, according to an author of two studies on the subject.

  • Know H. Todd, an associate professor of emergency medicine at Emory University, and other researchers compared the charts of black patients and white patients -- a little more than 200 total -- with broken arms or legs who were treated at an unnamed Atlanta hospital from 1992 to 1995.
  • According to the study, published in the January 2000 issue of the Annals of Emergency Medicine, 43 percent of black patients with fractures of the extremities received no pain medication in the emergency room, while only 26 percent of white patients with similar injuries went untreated for pain.
  • Todd was an author of a similar study in Los Angeles, published in the Journal of the American Medical Association in 1993, that found white patients with broken bones were 64 percent more likely than Hispanic patients with similar fractures to receive pain medication in the emergency room.

Because neither doctors nor patients were interviewed for the Atlanta study, Todd says the report can not offer a definitive explanation for the disparity. He speculates that emergency room physicians, 85 percent of whom are white, might unknowingly empathize with patients of their own race, and tend to under-empathize with the pain of another. In addition, there are cultural differences in pain expression.

(A New York Times news report on the study did not give other characteristics of the patients, such as their age, information on the circumstances of the injury -- e.g., team sports play or auto accident -- or emergency room conditions at the time the treatment was given.)

Source: Gabrielle Glaser, "In Treating Patients for Pain, a Racial Gap," New York Times, December 28, 1999.


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