American Medicine and Systemic Racism

WARNING: GRAPHIC CONTENT, some of the quotes and information may be upsetting. I share it to shed light on our past and the way it affects our society today.

A 2016 study revealed that half of the medical residents surveyed believed that African Americans felt less pain. (1)

WHERE could this idea have come from?

From the earliest days of modern medicine:

“[blacks] bear surgical operations much better than white people and what would be the cause of insupportable pain for white men, a Negro would disregard…” – Dr. Charles White

“When we come to reflect that all the women operated upon in Kentucky, except one, were Negresses and that these people will bear anything with nearly if not quite as much impunity as dogs and rabbits, our wonder is lessened.” – Dr. James Johnson

Dr. James Marion Sims, who is the “father of modern gynecology” and who had a statue in Central Park until 2018, also believed that African-Americans felt less pain, and so he perfected his surgical interventions on enslaved women and refused to offer them the most basic anesthetic of the day. When he performed the surgeries on white women, he, of course, utilized pain medicines to keep them comfortable. (2)

We may live in a different time, but foundational biases still impact our healthcare system today as the 2016 study mentioned above shows. These biases have consequences:  

  • A 2019 Meta-Analysis showed that African-Americans were less likely to receive pain meds in the ED than white people (3)
  • A 2019 study showed that racial biases in pain perception led to biases in pain treatment decisions (4)
  • A 2013 study showed that African-American were less likely to receive pain medicines when presenting to the ED with abdominal pain (5)

When a racial bias leads to a diminished outcome for a certain race within a certain system, we call that institutional racism. We are a part of a culture that transmits ideas to us, both implicitly and explicitly, and these ideas have real-world consequences. To overcome these biases, we have to expose their origins, recognize their impact on us and the systems of which we are apart, and pursue equality. Continued denial is not an option because it only leads to more suffering.   

1 – https://www.pnas.org/content/early/2016/03/30/1516047113.abstract

2 – Quotes and info taken from “Medical Apartheid” by Harriet A. Washington

3 – https://www.ajemjournal.com/article/S0735-6757(19)30391-2/fulltext

4 – https://pubmed.ncbi.nlm.nih.gov/31070440/

5 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4074647/

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