Perceptual contributions to racial bias in pain care

The pain of Black Americans is pervasively and persistently underdiagnosed and undertreated. In addition to other individual- and structural-level factors, research from my lab demonstrates that low-level perceptual disruptions may also contribute, in part, to disparities in pain care. This bias is supported by differential engagement of configural face processing, persists when rigorously controlling stimuli, and is generalizable across stimulus sets, sample types, and perceiver race. In recent work, we’ve examined the speed and spontaneity of racial bias in pain perception, as well as other target and perceiver-level factors that may exacerbate or ameliorate this perceptual bias. We demonstrate that this bias is still evident at minimal presentation durations (as low as 33ms), most apparent for ambiguous pain expressions, and not attenuated by cognitive load—suggesting that this bias is not dependent on effortful processing. In a separate set of studies, we observe that target gender reliably moderates the effect of race on pain outcomes: racial biases in both pain perception and treatment are larger for male (versus female) targets. Finally, we’ve examined individuation as a potential means of reducing racial bias in pain perception. While motivating individuation reduces overall thresholds for seeing pain, its effect on racial bias in pain perception is relatively small. Addressing perceptual contributions to pain disparities will require accounting for their automatic nature and understanding the cases and contexts in which this bias is more likely to emerge. Together, we hope this work will serve as a foundation for future interventions aimed at eliminating racial disparities in pain care.