Thread by @AmitAryaMD

Are we racist in healthcare? Here’s some evidence about racial bias in pain management (THREAD):

#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. 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. pubmed.ncbi.nlm.nih.gov/28956669/

3/ Ethnic minority patients with metastatic cancer were three times less likely to receive adequate pain management. nejm.org/doi/full/10.10…

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.
ncbi.nlm.nih.gov/pmc/articles/P…

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.
nytimes.com/interactive/20…

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 It has largely been replaced by implicit bias- thoughts & feelings outside of conscious awareness, which directly affect clinical decision making.
acc.org/latest-in-card…

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)