Racism can kill you, and a new medical study proves that racial discrimination is causing Black children extreme pain in the ER.
study from JAMA Pediatrics that examined the pain management of
children in hospital emergency departments found that Black and Latino
children being treated for acute appendicitis, a painful inflammation
of the appendix, are less likely to receive painkillers than white
authors, Dr. Monika Goyal of the Children’s National Health System in
Washington and colleagues, based their findings on data from the
National Hospital Ambulatory Medical Care Survey from 2003 to 2010 to
analyze the administration of opioid medications (a synthetic narcotic
derived from opium) such as morphine and Percocet, and nonopioids
available over the counter such as Tylenol.
an estimated 1 million children diagnosed with appendicitis, only 56.8
percent of patients received any analgesia, although these painkillers
are highly recommended for appendicitis cases, and only 41.3 percent
received any opioid analgesia. However, the study found that Black
children were less likely to receive any pain medication at all for
moderate pain, and less likely to receive opioids for severe pain than
their white counterparts.
findings suggest that there are racial disparities in opioid
administration to children with appendicitis, even after adjustment for
potential confounders. More research is needed to understand why such
disparities exist. This could help inform the design of interventions
to address and eliminate these disparities and to improve pain
management for all youths,” the study said. “Our findings suggest that
although clinicians may recognize pain equally across racial groups,
they may be reacting to the pain differently by treating black patients
with nonopioid analgesia, such as ibuprofen and acetaminophen, while
treating white patients with opioid analgesia for similar pain.”
Eric Fleegler and Dr. Neil Schechter of Boston Children’s Hospital and
Harvard Medical School also noted in a related editorial that without
any physiological explanation for the difference in treatment, “we are
left with the notion that subtle biases, implicit and explicit,
conscious and unconscious, influence the clinician’s judgment.”
explanations for the results include an unconscious racial bias against
African-American children, an unwarranted fear of opioids, or a notion
that Black children have a higher threshold and tolerance for pain.
Perhaps some physicians harbor a racist belief, given the
criminalization of Black people and the war on drugs, that Black
children are more prone to addiction. And even worse, perhaps some
doctors even feel that Black and Latino children are less worthy of
receiving the medications in the first place.
controlling pain in medical patients is widely viewed as a cornerstone
of compassionate care, the authors recognize, “significant disparities
remain in our approach to pain management among different populations.”
Further, they conclude that as strategies exist to solve this problem,
more can and should be done.
studies have addressed the racial disparities in treatment, including
painkillers, among adults over the past three decades, but fewer
studies have examined the differences in care given to Black children.
It is particularly unsettling that our most vulnerable members of
society, both as children and as those who are already exposed to
racism in their daily life, are also victimized by the medical
profession in such a blatant manner.
results are shocking, though not surprising to those who understand
that this latest study is part of a longstanding pattern. Racism is not
merely the Klansman who wears a hooded sheet, or the white person who
uses the n-word. Rather, racism is a system of exploitation that acts
to the detriment of Black people, by design and with purpose, often
yielding life-threatening and painful results.
There are years of medical experiments, of using Black people as human guinea pigs, including theTuskegee experiment,
in which the federal government left Black men infected with syphilis
untreated for decades. In the past, medical knowledge was sought based
on torture and unethical experimentation on Black prisoners, pregnant
women, and other unsuspecting victims.
Unfortunately, this sad legacy lives to this day.