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Racial Biases in Pain Care Recommendations and the Moderating Effect of Providers’ Experience with Diverse Communities

Despite Black Americans reporting greater pain than White Americans (Mechlin et al., 2005; Rahim-Williams et al., 2012), Black Americans’ pain is underestimated and undertreated (Mack et al., 2018; Schoenthaler & Williams, 2022). Previous work suggests clinician biases (e.g., implicit prejudice, empathy gaps) may contribute to pain treatment disparities across race (Drwecki et al., 2011; Moskowitz et al., 2012). However, past work has yet to systematically examine pain treatment of multiracial individuals, who may be subject to discrimination documented in monoracial pain care but also may experience unique biases in healthcare settings with implications for equitable care (Chen et al., 2018; Freeman et al., 2016; Kteily et al., 2015). A pilot study conducted with a convenience sample indicated racial bias in pain care recommendations, where Black/White multiracial individuals recieved the least intensive pain care recommendations. The current work adopts an experimental approach and recruits a sample of pain care providers to investigate clinician biases in pain care for Black, White, and Black/White multiracial hypothetical patients. Pain care providers’ experience with diverse communities is examined as a moderator to better understand how diversity exposure may attenuate or exacerbate patterns of racial bias in pain treatment recommendations. In sum, this work investigates patterns of clinician racial biases in pain treatment and potential moderation by experience with diverse patient populations (e.g., Are racial biases in pain care stronger or weaker for healthcare providers serving more diverse communities?). As an aspiring healthcare provider in a sub-field that commonly treats pain (i.e., emergency medicine), it is important to me to better understand and actively contribute to our collective understanding of how racial biases interfere with equitable and just pain care. The goal of this work is to motivate more equitable and higher quality care for all patients.