Ignorance: Super Spreader of Racism
Dear Leading Ladies,
We are no longer surprised when we hear that poor people and people of color have a harder time accessing good health care because they don’t have adequate insurance or don’t get sick days at work. We get that co-pays can make it difficult for many to purchase needed medications or go to doctors’ appointments.
But what we find astounding is the ignorance rampant among doctors and medical students that perpetuates racism and inequities in patient care.
In a recent article in the Boston Globe Magazine about the patients trying to refuse treatment based on a provider’s race, journalist Andy Levinsky mentioned a 2016 study by researchers at the University of Virginia which concluded that “about 40 percent of first- and second-year medical students believed that Black people had thicker skin than white people, a myth that led practitioners to believe that Black patients have a higher tolerance for pain and a lesser need for relief.”
Association of American Medical Colleges
Myths about pain
The Harvard Global Institute, in a 2020 article entitled “Racial bias in medicine,” wrote about the UVA study that “The medical students and residents who endorsed false beliefs like these were more likely to rate the pain of a black patient as less severe than that of an otherwise identical white patient and less likely to recommend treating black patients’ pain.” Moreover, another study found that relative to other racial groups, physicians are twice as likely to underestimate Black patients’ pain.
Needless to say, “the myth that Black people can tolerate pain better than individuals of other ethnicities is just that—a myth—rooted in racism and bias,” says Dr. Kecia Gaither, a Bronx-based ob-gyn. This notion is based on other erroneous beliefs, including that Black people have less sensitive nerve endings. As quoted on healthcentral.com, Dr. Gaither believes that the Virginia study “clearly articulates the biases and structural racism that exists within the medical arena and is still present in the 21st century.” Racism? Yes, but incredible ignorance as well.
A corollary myth is that Black people exaggerate their pain, though this was not researched in the UVA study. Dr. Gaither reports witnessing this myth personally, where Black patients are perceived as behaving in a histrionic and attention-getting manner to receive pain medication. She points to medical textbooks that re-enforce this myth with actual statements that Blacks report higher pain intensity than other cultures. Furthermore, as reported in the New York Times in 2022, Black patients are more likely than white patients to be noted in their medical records as non-compliant or non-cooperative. “It’s not so much whether you should never use these words, but why are we applying these words with so much more frequency to Black patients?” said Michael Sun, the lead author of one study. “Rather than assume the patient is lacking in motivation or disengaged,” he said, “the medical team should inquire whether the patient is facing financial barriers, transportation difficulties or other obstacles to adhering to treatment, such as illiteracy or trouble with English.”
When does ignorance become racism?
Yet another discriminatory attitude based on ignorance, misconceptions, and, yes, racism, harms the health of Black people. As stated in the Harvard Global Initiative, studies indicate that “physicians, white ones in particular, implicitly prefer white patients, falsely viewing them as more intelligent and more likely to follow professional advice.”
The result of these attitudes on the part of our health providers is that too many Black patients do not receive the pain treatment and relief they need and deserve. Their reports of pain are dismissed and they are disrespected by a system they have long distrusted, often for good reason.
Such attitudes about pain tolerance and less sensitive nerve endings harken back to earlier centuries when such nonsense was used to justify slavery and the cruel treatment of the enslaved; medical experiments without consent on men and women of color; the assumption of other untruths such as the mental inferiority of Black people. But in the 21st century? Among our medical students and physicians? How can this be? Certainly, we can expect our medical schools to do a better job of teaching the truth about human anatomy and physiology, can’t we?
For the love of humanity,
Therese
Judy
Didi
Leading Ladies Executive Team