“Perceptual contributions to racial bias in pain care”
Several decades of work demonstrate persistent racial and ethnic gaps in pain care in the United States. In particular, the pain of black Americans is undermanaged across virtually all care contexts. Recent work in our lab demonstrates that these gaps in care may stem, at least in part, from a perceptual source. White perceivers display more stringent thresholds for pain expressed on black faces, versus white faces—even when participants viewed digitally rendered black and white stimuli making exactly the same expressions of pain. This gap in perception stems from disruptions in configural face processing, and facilitates the influence of race on pain treatment decisions, over and above the influence of explicit prejudice and stereotypes. However, while racial bias in pain perception is not solely explained by low-level differences between white and black faces, these factors do exert a demonstrable influence. Specifically, darker skin tones (independent of race) impede pain perception, while racially prototypic structural features may exacerbate racial bias in pain perception. Moreover, while racial bias in perception generalizes across target gender, this effect is considerably larger for pain expressed by male versus female individuals. Taken together, this work builds the foundation for a social perceptual model of racial bias in pain care, and lays the groundwork for the elimination of longstanding inequities in pain care.