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Report finds patients of colour less likely to get pain meds among racial issues plaguing health care

Posted: June 10, 2020

(June 9, 2020)

By: Len Gillis,

Ontario Health Coalition cites numerous studies showing the amount of pain relief can depend on a person’s skin tone

The amount of pain relief a person receives can often depend on their skin tone, stated a report by the Ontario Health Coalition released this month, citing studies from several journals.

The findings of these studies show racism is a public health crisis in Ontario, said a statement and some statistics provided by the Ontario Health Coalition (OHC). The OHC is a lobbying and advocacy group that promotes universal public health care in Canada.

The group released a statement on June 5 in support of the rising protests against what it called anti-black racism.

“Across Canada and the United States, and around the world, health sector organizations are declaring anti-Black (OHC has chosen to capitalize, which has preserved in quotes) racism a public health crisis,” said the OHC statement. “We support this declaration and add our voices to it. Anti-Black racism is also a violation of fundamental human rights, of core principles of justice and is a grave threat to democracy.”

It is similar to the statement released last week by Public Health Sudbury and Districts, the official public health agency for Sudbury and surrounding communities. That statement, signed by Medical Officer of Health Penny Sutcliffe said racism and oppression causes poor mental health as well as affecting physical health.

OHC also revealed there are more people of colour living in Toronto neighbourhoods that have the highest rates of coronavirus infections. The statement also cited a study about pain treatment for black people being less than what has been provided for white people.

“Black people are routinely denied access to the health care services that are a basic human right,” OHC stated. “Black children are given lower levels of pain management as white children. Black women receive cervical cancer screening at lower rates than any other population group. People suffering from sickle cell anemia are treated as drug seekers.

“People living with mental health conditions are turned away or offered culturally unsafe healthcare, leading to increased rates of suicide and suffering.”

The statement also quoted a recent Twitter thread from Dr. Amit Arya of Toronto that suggested evidence of racial bias in pain management.

Arya cited numerous studies in the Twitter thread he produced, showing:

A 20-year meta-analysis and systematic review revealed black patients were 22 percent less likely than white patients to receive any pain medication.

Black patients with painful injuries such as fractures, burns or penetrating injuries were less likely to receive pre-hospital pain management.

Ethnic minority patients with metastatic cancer were three times less likely to receive adequate pain management.

About half of white medical students and residents endorsed incorrect racist beliefs about black patients (eg. Black skin is thicker than white skin). This led to lower rating of Black patients’ pain and undertreatment.

Historically violent and cruel “experiments” were done to prove racist beliefs that differences between black and white people were more than cultural – rather black people were biologically different, and had thicker skin.

Nowadays, biological racism has become less socially acceptable. It has largely been replaced by implicit bias – thoughts and feelings outside of conscious awareness, which directly affect clinical decision making.

Arya’s statement also suggested that raced-based data should be collected in health care treatment so as to measure health quality and equity.

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