A significant amount of research globally indicates that patients from minority ethnic groups often face challenges in having their pain recognized and treated adequately. Unfortunately, these disparities extend from childhood into end-of-life care.
Studies across various healthcare environments—like emergency rooms, maternity services, and cancer treatment—show a consistent pattern. Findings reveal that individuals from minority backgrounds often have to exhibit higher levels of pain before obtaining care, and even when their pain is acknowledged, the treatment they receive is frequently less effective.
Childhood
From a young age, children from minority ethnic backgrounds tend to have their pain downplayed, resulting in subpar treatment compared to their white peers.
A 2024 study from the University of Delaware looked into whether racial bias influences perceptions of children’s pain and the recommended treatment. Participants viewed computer-generated images of children from various ethnicities displaying varying degrees of pain.
The results showed that pain expressions in black boys were less readily recognized than those of white boys, necessitating stronger signs of discomfort for recognition. This suggests clear biases in how pediatric pain is perceived, with those less likely to notice pain in black children also less inclined to recommend pain management.
In a 2020 study led by Monika Goyal at Children’s National Hospital in Washington, researchers examined pain management disparities among children with fractures in U.S. emergency rooms. While minority children were more likely to be given medications like ibuprofen or paracetamol, they were significantly less likely to receive opioids.
Dr. Goyal stated, “When considering optimal pain relief, minority children were often sent home still in pain compared to their white peers. Even after adjusting for injury severity and pain intensity, minority children faced obstacles in receiving opioids for their fracture pain.”
Other studies indicate that black children with appendicitis were 80% less likely to be prescribed opioids for significant pain compared to white children. Complementing these findings, a 2024 study from University College London highlighted that black children were four times more likely than white children to face complications post-surgery, including severe pain.
Maternity Care
The pain disparity among women giving birth is well-documented. Research by The Guardian noted that black women in England are almost twice as likely to have their births scrutinized for safety issues compared to white women.
Moreover, black women are nearly three times more likely to die from complications during childbirth in the UK. An interim report from the National Maternity and Neonatal Investigation included anecdotes of Asian women being viewed as “princesses”—implying they were overly demanding—while black women were stereotyped as possessing “tough skin” and were expected to tolerate pain without complaints.
One participant shared, “I feel like, for us black ladies, they think we can handle the pain, even when we say we’re hurting.”
Additionally, several black women described their experiences of being perceived as “angry or aggressive,” which impacted their care. One woman recounted, “I was begging for help … I felt like they saw me as that aggressive, angry black woman. But that isn’t who I am.”
A 2025 survey conducted by FiveXMore revealed that 23% of black women did not receive the pain relief they requested during childbirth, and 40% received no explanation for this denial. One participant recounted asking for pain relief only to be told there was none available, while others were receiving it.
The survey also noted that when black women didn’t vocally express their pain or appeared less distressed, healthcare providers often assumed they were coping well, influenced by stereotypes about their resilience.
Emergency Care
A 2016 study from Boston University found that black patients were around half as likely as white patients to receive opioid prescriptions in emergency departments.
This research, covering over 60 million emergency visit records between 2007 and 2011 for individuals aged 18 to 65, indicated that black patients were significantly less likely to be prescribed opioids for common pain issues like toothaches and back pain.
“Sadly, this study confirms what we already understand: black patients are frequently underserved when it comes to pain management—and much of it relates to their racial background,” said Prof. Keisha Ray, the study’s lead author.
For individuals suffering from sickle cell disease, which predominantly affects those of African descent, inadequate care and racism in healthcare settings has been widely reported. A 2021 report by the Sickle Cell Society highlighted that patients often face dismissive attitudes regarding their pain, especially in emergency rooms, where their complaints may not be taken seriously.
Chronic Pain
Research has shown that the chronic pain associated with sickle cell isn’t the only area where black patients encounter poorer health outcomes. A 2026 study examining a group of U.S. adults suffering from chronic lower back pain found that black patients reported more severe pain compared to white patients, regardless of socioeconomic and clinical factors.
Dr. John Licciardone from the University of North Texas commented, “Our goal was to separate the effects of race from social disadvantages on factors such as pain level and quality of life. These results are striking, emphasizing that racial disparities in pain are influenced by sociocultural factors rather than merely genetic ones.”
Another study focused on chronic pain among Parkinson’s patients at King’s College London discovered that 83% of white patients were given pain relief, while only 48% of black and 43% of Asian patients received similar treatment. This disparity was most pronounced for opioids, with only 4% of black and Asian patients receiving this form of pain management compared to 43% of white patients.
Cancer and Palliative Care
In England, nearly one-third of individuals will succumb to cancer, and the ethnic pain gap is evident during cancer treatment as well. A significant study from the University of Hull found that cancer patients from black, South Asian, mixed, and other ethnic backgrounds were often prescribed fewer opioids and lower doses of pain medications than their white counterparts, even when controlling for various factors.
Jonathan Koffman, the lead researcher, noted that this was the first extensive population-based study in England exploring the relationship between ethnicity and opioid prescriptions in the final months of life for cancer patients.
“Access to adequate pain management is a human right. A significant majority of cancer patients experience pain as they near death, and effective treatment is crucial—not just for comfort, but for dignity and quality of life,” he emphasized.
The study found that individuals from minority backgrounds were more likely to have multiple visits to emergency departments and hospital admissions in their last months—a sign that their pain issues may not be adequately addressed in the community.
