EMS
workers may be undermining the care of Black patients. In a most
recent example of racism and unconscious bias in the health
profession, a study found that a patient’s race may determine
whether he receives pain medication in the ambulance and on the way
to the hospital.
The
study
—
which was led by Jamie Kennel, the head of emergency medical services
programs at Oregon Health and Science University and the Oregon
Institute of Technology — found that paramedics and emergency
medical technicians are 40 percent less likely to provide pain
medication to black patients than to white ones.
A
new study in Oregon has found that paramedics and emergency medical
technicians are 40 percent less likely to provide pain medication to
Black patients than to white ones. Credit: Getty Images, Paul Burns
Although
racism in the health care professions and the disparate quality of
care provided to Black people and other people of color versus their
white counterparts has been well documented, previous studies have
not isolated the role of race in EMS treatment, as opposed to
socioeconomic status, the report noted. The study, which examines EMS
data from Oregon, investigated “EMS pain management treatment
for racial minority patients including (1) pain assessment, (2) pain
medication administration, and (3) opioid pain medication
administration for traumatic or painful injuries” to “isolate
race as a risk factor in the receipt of pain medication in EMS
traumatic and painful injuries.”
While
the report found EMS pain treatment disparities for
African-Americans, there was no evidence of differences in treatment
among Latinx patients. While this is just one study, the eye-opening
findings are in line with a growing trend of studies on racial bias
in the delivery of health services. These revelations on the racial
disparities of treatment help explain — along with lifestyle,
socioeconomic status and zip code — the disproportionately
negative health outcomes for Black people, the higher rates for
developing certain diseases, and the higher rates of death.
For
example, according to a 2016 University of Virginia study,
researchers came to the disturbing realization that doctors are more
likely to prescribe pain medication to white patients than to Black
patients because they
believe Black people do not feel pain
in the same way. A survey of white medical students, residents and
laypeople found that significant percentages of each group believed
false medical assertions about Black people, such as that Black
people have thicker skin than whites, less sensitive nerve endings,
or that Black blood coagulates more quickly that white people’s
blood.
Research
suggests doctors prescribe opioids for patients with chronic
non-cancer pain on the basis of race, with physicians less likely to
fill opioid prescriptions for Black Medicaid beneficiaries,
particularly when the providers are in the areas of obstetrics and
gynecology, internal medicine, and general practitioners/family
medicine physicians. Black people also suffer from less effective
treatment for drug addiction, and there is evidence that doctors will
not prescribe painkillers to patients of color under the assumption
they are drug abusers seeking drugs to meet their dependency rather
than a medical need.
One
study
in the journal PLOS concluded that there were “significant
racial-ethnic disparities” in the prescription of opioids in
hospital emergency departments for “non-definitive”
conditions such as abdominal or back pain — conditions that
cannot be confirmed through medical diagnostics tools and are often
associated with “drug-seeking patients” who want a fix.
In contrast, there was no such disparities for patients with
toothaches, kidney stones and long-bone fracture. The report suggests
the disparities in prescriptions could widen the existing racial
health gap, and perhaps could even explain why poor whites are
disproportionately impacted by the opioid epidemic.
“Essentially,
the systematic racism within the health care system has led to
increased addiction and overdoses in low-income white areas, but
also, (to) insufficient treatment among communities of color,”
said Joseph Friedman, a medical student at UCLA’s David Geffen
School of Medicine, and lead author of a study on racial bias in the
opioid epidemic. Friedman argues this has resulted in a “double-sided
epidemic”
in which low-income white communities have widespread addiction, but
neglected Black communities are not prescribed the medications they
need to treat their pain.
Further,
Black children are among those who receive the short end of the stick
in terms of pain management. For example, Black and Latino children
in the emergency room are less likely to receive painkillers for
acute
appendicitis
than white children, which may be attributed to a racist notion among
doctors that Black children are more easily addicted, have a higher
tolerance for pain, or simply are not worthy.
Further,
there are racial disparities in the wait time of Black patients to
see a doctor. According to a JAMA internal medicine study, Black,
Brown, unemployed and less educated people waited 25
percent
longer to see a health care professional. When Black patients waited
99 minutes to see a doctor, whites waited only 80 minutes. In the
same study, Latinos waited 105 minutes, and other nonwhite people
waited 83 minutes to see a physician.
The
evidence shows that racism is painful, and it can be unhealthy.
This
commentary was originally published by AtlantaBlackStar.com
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