Painfully prejudiced? Racial stereotypicality and gender in pain perception, treatment, and empathy

Abstract

Black and female individuals are systemically undertreated for pain. While studies on racial biases in pain care have predominantly focused on the effects of between-race differences, few have considered the potential role of racial stereotypicality (how closely an individual resembles “typical” features of their race). Past research demonstrates that Black individuals perceived to be higher in racial stereotypicality face significant disadvantages in various domains, such as criminal justice and education, due to stronger associations with negative racial stereotypes. Findings suggest that stereotypicality may also have implications for healthcare. Therefore, the present study used a 2 (Racial Stereotypicality: Less Stereotypically Black vs. More Stereotypically Black) × 2 (Gender: Male vs. Female) between-subjects design to investigate how targets’ racial stereotypicality and gender influence lay perceivers’ pain perception, empathy, and treatment decisions. Furthermore, this study examined the relationships between perceivers’ perceptions of targets’ trustworthiness and attractiveness and their empathy toward targets. In an online experiment on Qualtrics, participants (N = 233) were randomly assigned to view one of four medical vignettes, each containing a photo insurance card, medical chart, and pain rating. Participants then rated the target’s pain, indicated how likely they would be to recommend a series of treatments for the target, completed a measure of empathic concern toward the target, and rated the target’s trustworthiness and attractiveness. Racial stereotypicality and gender did not significantly affect perceived pain, empathy, and most treatment decisions. However, perceivers’ empathy was positively correlated with targets’ perceived trustworthiness and attractiveness. This study provides a valuable starting point for further investigation into the role of racial stereotypicality and gender in pain care. Future research with working clinicians and advanced analyses are essential to deepening our understanding of the complexities of pain care disparities, and ultimately, achieving equitable pain care.