If you’re black, Hispanic, or “Asian/other,” you might want to make sure your voice is heard loud and clear the next time you have to make a trip to the ER. Research published in the Journal of the American Medical Association shows that over the past 13 years, white patients were prescribed powerful opioid painkillers 31% of the time, versus 23% for blacks, 24% for Hisanics, and 28% for Asians and “others.”
According to Reuters, “the study found the largest racial disparity in providing stronger medications was found among patients in the most pain and those aged 12 or younger.”
“There is no evidence that nonwhites have less severe or different types of pain when they arrive in the emergency department,” Pletcher said. “We think our data indicate that opioids are being underprescribed to minority emergency department patients, especially black and Hispanic patients.”A factor may be that white patients are more likely to expect and demand relief from pain and better convey their symptoms in comparison to minority patients, the report said. Whites — who are more likely to have health insurance — may also be overprescribed the drugs, it said.
From Scientific American:
The investigators acknowledge that it is conceivable that the disparity represents overprescribing to white patients, but they think it a more plausible explanation is true undertreatment of pain in minority patients. This may not be a result of physician bias but could reflect expectations and assertiveness of the patients.
“Racial gap in ER opioid use still persists” [Scientific American]
“Minorities less likely to get pain relief-US study” [Reuters]
(Photo: Getty)
More From Consumerist
-
Detroit Homeowners Sue Morgan Stanley Over Racially Biased Predatory Lending Practices
-
This Is Why People Hate Health Insurance Companies
-
Wells Fargo Receives $175 Million Slap On Wrist Over Discriminatory Loan Allegations
-
Millions Of Older Americans Are At Risk For Losing Their Homes
-
Georgia Counties Sue HSBC, Say Bank’s Prejudiced Loans Cost Them Millions
@canerican: Yeah it’s been a tough run for the conservatives in this country of late. Sucks being in charge, eh?
@Blowfish: Because it may not have anything to do with skin color. It is possible that you can replace Blacks and Latinos with uninsured and have the same numbers. Or, inner city hospitals perscribe the drugs less, and you could have the same result.
The article makes the hospitals sound racist, when that is probably not the case.
Doesn’t seem to me that the numbers prove anything. The % are all pretty close, I wonder what the margin for error is?
I can’t stand these “studies” that cry racism at everything but that might be because I don’t really have to deal with it in the same way that others do. That and I wasn’t really exposed to it growing up.
Hey Chris, I know you mean well, but please guys, dont bother posting any articles like this, all it usually amounts to is a Racial Flame War (RaFlaWa FTW). Not an inteligent debate of the facts (or lack there of).
I for one make a decent living, have health insurance and do not exhibit “drug seeking behavior” but I can remember a couple of times that I’ve went to the ER in some serious pain and been given a tylenol, after being asked and describing my pain as an 9 out of 10. I was just in too much pain to even argue (and nervous about how I’d look to the doctor). If it wasnt for the fact that my fiancee followed the doctor and gave him a what for then that probably would have been the end of it.
But I dont think that counts because both he and I were black.
But then again, another time I went with a sprained ankle, the doctor perscribed me percoset…I looked at her like “What?”, never even filled the perscription…just needed anti inflamitory pills.
She was white.
My point as always is…I dont have to have one.
In other news…why is it that whenever the race is thrown into an issue like this, the answer is either racist or not-racist.
If a white guy snubs a black guy does that automatically make him racist? Maybe he’s just an ass hole, maybe he didnt see him, maybe he was in a rush.
Even as a black guy, I think both sides run to their racial defense positions a bit to fast these days.
I hate all of you equally.
@Invisobel:
“It is also a measure of many minority’s assertiveness and sense of entitlement. It’s a cultural thing…”
Nice touch.
I know when I’m in pain, I typically have a sense of entitlement, I treat my doctors just like waiters at a high end dining establishment.
“My opiods are cold, send them back and bring me a manager”
Oh and that whole wanting to get out of the hospital, that transends all gender and race.
you know really there is nothing to this story. I mean really is there much of a variation on the pecentages?
We’re only talking a few points.
I have a feeling that there are a LOT of factors at play here, not just one. Sure, it’s probably mostly economics. However, ignoring the possibility of racial bias is stupid because we know it exists elsewhere in society. Ignoring the possibility of cultural differences in how people express pain is stupid as well.
I know the tendency, especially as a white guy, is to totally blow off any study that implies that people are showing racial bias. Blowing it off doesn’t make it untrue, though, and it sure alienates everyone who isn’t white when people refuse to acknowledge the existence of racism.
In any case, this study doesn’t tell us anything except that there’s a difference in the treatment people receive. Period. It’s one of those “warrants further study” studies.
P.S. “hispanic” and “latino” are not races. You can be black, native american or white and be hispanic.
I’ve had to deal with a number of fake or stolen prescriptions (and an even larger number of ones I suspect to be fake but cannot conclusively prove). The decision to further investigate a prescription is generally one based on judgment; I look at the person, I look at the prescription, and if something seems funny, I’ll look into it.
As it turns out, the VAST majority of the people bringing in phony prescriptions are African American or Mexican. Granted, the pharmacy I work at has a minority customer base of around 80%, so that could easily be the cause of it. Or, maybe I’m subconsciously profiling because somehow white people don’t set off my “spider sense” the way that minorities do, all other factors being equal.
So I can certainly understand the dilemma of a doctor who may recognize signs of drug-seeking behavior and follow his instinct by not prescribing them a narcotic. At some point, the doctor has to look at the person and say, “From what I can tell of this person, would they be the type to divert, misuse, or abuse a prescription for a narcotic?”
So where does that cross the line from “good judgment” to “profiling”?
It’s interesting that the study didn’t mention racial profiling as a possible cause of the disparity.
It’s not just the pharmacists who have to make a judgement call, as Hambriq notes in his comment, but of course the prescriber as well. I have a hard time believing that racial profiling isn’t a factor here, especially as it’s (unfortunately) no longer taboo in this country.
I think this is just because we white people are pussies.
This doesn’t seem to make any attempt to measure need for the opioids. Maybe people just have different needs. Maybe poor people, who are statistically likely to be minorities, come to the emergency room for more minor things than more well-off people, who have other avenues of treatment. If lots of white people went to the ER instead of to their regular doctor for relatively minor things, then the probability of white people being prescribed high-power painkillers would decrease.
Where do I go to apologize for being white?
Jesse Jackson
I don’t have access to the full article (does anyone in college have access to the JAMA articles?) but I found this in their current issues – [jama.ama-assn.org] Might give more indication as to how they conducted their study. What stood out to me was:
Opioid prescribing for patients making a pain-related visit to the emergency department increased after national quality improvement initiatives in the late 1990s, but differences in opioid prescribing by race/ethnicity have not diminished.
Basically, they studied current numbers through study and compared them to past numbers…and there was no difference.
@Wormfather:
If you could in fact be nervous about what your doctor would think you most likely were not a 9 or a 10 on the pain scale.
I have seen people get to that point they just sit there and scream or cry.
They got strong pain killers in the ER and they were black. Their pain was rated “8.”
@asherchang2: The consumerist write up had no conclusions. The article while statically relevant made no attempt to determine why. This is because their thesis was not on race disparity. It just turned up as an interesting trend given the data. I’m sure this will spur a future study.
@canerican: “Of course the White Conservative Male is always wrong (unless its the Jews, right?)”
Why hasn’t this been flagged yet?
@techguy1138:
Agreed. The writeup draws no conclusions, and that’s probably a good decision.