Past research has shown large racial disparities in pain care in the United States. In particular, the pain of Black patients is consistently under-diagnosed and under-treated. Black Americans are less likely to be prescribed pain medication. When they do receive pain medication, they are prescribed lower doses on average. Beyond the threat this inequality in pain care presents to the health and well-being of minority individuals, unequal treatment of pain has consequences for national productivity. As one example, untreated or mistreated pain is associated with difficulty in returning to work following injury. Theory and research in social psychology has identified several factors that contribute to racial bias in pain care, including stereotypes, implicit racial bias, and gaps in empathy. This project expands on past research by including a separate and distinct perceptual basis for this bias in pain care. The central premise is that race shapes the visual perception of painful expressions on others' faces, triggering a cascade of biased processing and behavioral outcomes. By bringing together theory and research in social psychology, vision science, cognitive neuroscience, and health care, this project seeks to develop a social perceptual model of racial bias in pain care. It will reveal the psychological and perceptual mechanisms that contribute to racial disparities in pain treatment and help to develop potential interventions to reduce the bias.
This project is organized around a set of eight behavioral and neuroimaging experiments that examine the psychological roots, neural bases, and behavioral consequences of racial bias in pain perception. The studies consider whether race influences the recognition and treatment of pain by disrupting the visual perception of painful facial expressions. One expected effect is that perceivers see painful expressions on Black faces earlier than they do on White faces, and that this difference can account for some of the known biases in treatment, over and above the influence of explicit stereotypes or implicit racial bias. The research aims to uncover aspects of the perceiver and of the person being perceived that make the bias larger or smaller, focusing on factors such as social status, racial prototypicality, and interracial contact. The project also considers whether medical health professionals show the same perceptual bias, and whether the bias is observed when self-report information about pain experience is available. As a potential focus for intervention, the research tests whether brain and behavioral responses associated with visual biases in pain care are reduced by increased familiarity of and experience with Black faces. The existence of racial disparities in pain care undermines public health and threatens national productivity. This project contributes to a foundation of basic knowledge on which future interventions can be based.
This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.
