Minorities Less Likely to Get Pain Relief

Off Topic
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[u]Minorities less likely to get pain relief in U.S. [/u]
WASHINGTON (Xinhua) – Despite increases in the overall use of opioid drugs to relieve severe pain, black and Hispanic patients remain significantly less likely than whites to receive these pain-relievers in emergency rooms, according to a new study released Tuesday in Journal of the American Medical Association.

The study examined treatments for more than 150,000 pain-related visits to U.S. hospitals between 1993 and 2005. It found that 31 percent of whites received opioid drugs compared with only23 percent of blacks and 24 percent of Hispanics. About 28 percent of Asians received the drugs. 

In contrast, non-opioid pain relievers, such as acetaminophen and ibuprofen were prescribed much more often to non-whites (36 percent) than to whites (26 percent). 

"Studies in the 1990s showed a disturbing racial or ethnic disparity in the use of these potent pain relievers, but we had hoped that the recent national efforts at improving pain management in emergency departments would shrink this disparity," said Mark Pletcher, lead author of the study. "Unfortunately, this is not the case." 

"There is no evidence that non-whites 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 under prescribed to minority emergency department patients, especially black and Hispanic patients." 

Opioids are narcotic drugs used to treat patients with moderate to severe pain. Their use in emergency rooms in United States increased overall from 23 to 37 percent between 1993 and 2005. 

The authors call for ongoing education of physicians and nursing staff on treatment of pain, and promotion of cultural awareness. They also call for more education of patients to advocate for their own pain control. 

The paper suggests that changes in systems for pain management in the emergency department may be required, such as use of protocols allowing nurses to initiate pain control measures.

Editor: Yan Liang

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They are tougher.

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I’d be interested to see whether this information is controlled for income levels, which can correlate with race, particularly in the aggregate.

Also, this new study is somewhat related, and very interesting:

http://www.columbia.edu/~es2085/research/research.html

ABSTRACT:

Disparities in health outcomes between white Americans and minorities are well documented. Discrimination and unequal access to care are frequently cited explanations for the racial differences in mortality. It has been alleged that doctors treat minority patients differently or that they are trapped in facilities of inferior quality. I use a new dataset from the Department of Veterans Affairs and employ a novel estimation strategy to investigate the sources of the racial gap in mortality for the most expensive chronic condition in the elderly. In a sample of patients with equalized access to health care, I show that quality of the clinics or doctors is not the underlying reason for racial differences in black and white mortality. It is demonstrated that doctor competence significantly influences patient outcomes; that minorities and whites have access to similar physician quality, and that doctors treat patient similarly regardless of race. Differences in patient self-management trigger a racial mortality gap even when access and treatment are equalized. Considerable reductions in medical costs could be achieved by instructing patients about the importance of strictly following the therapy regimen. A special emphasis on educating minorities will have the added benefit of reducing the black-white mortality gap by at least two-thirds.