A study released Monday shows that Black children are given less painkillers than white children when being treated for acute appendicitis, an extremely painful inflammation of the appendix. While several studies have looked at the racial disparity in pain management among adults, this study focuses on the phenomenon among children. And it turns out that both Black children and Black adults can look forward to racial bias and racist treatment when seeking medical attention.
The article published online by JAMA Pediatrics on Monday presents a study which used data from the National Hospital Ambulatory Medical Care Survey from 2003 to 2010 to look at the use of opioid analgesia (which includes medications like Percocet ) and nonopioid analgesia (which includes over the counter household medicine like Tylenol).
Of an estimated almost 1 million children evaluated in Emergency Departments (EDs) who were diagnosed with appendicitis, 56.8 percent of patients received some for of analgesia and 41.3 percent received opioid analgesia. Among the patients with moderate pain, Black children were less likely to receive any analgesia than white children. Among the patients with severe pain, Black children were less likely to receive opioids(12.2 percent) than white children (33.9 percent.)
According to the study,
Our findings suggest that there are racial disparities in opioid administration to children with appendicitis, even after adjustment for potential confounders. More research is needed to understand why such disparities exist. This could help inform the design of interventions to address and eliminate these disparities and to improve pain management for all youths.
… although clinicians may recognize pain equally across racial groups, they may be reacting to the pain differently by treating black patients with nonopioid analgesia, such as ibuprofen and acetaminophen, while treating white patients with opioid analgesia for similar pain.”
Eric W. Fleegler, M.D., M.P.H., and Neil L. Schechter, M.D., of Boston Children’s Hospital and Harvard Medical School, Boston, asked in an editorial about the study,