A 2012 study showed a connection between the implicit, unconscious biases of a group of majority-white pediatricians for pain management between black and white women in a simulation of after surgery care (Sabin & Greenwald, 2012). The results yielded a strengthening of belief towards white women and a decrease for black women (Sabin & Greenwald, 2012). In time-series data, 20 years of studies on pain management in a variety of medical settings discovered that nonwhite patients are 22% less likely to receive any pain management or be believed about pain intensity (Sabin & Greenwald, 2012). As humans, we all have some form of implicit bias towards people or things. Healthcare providers are no different.
A factor to these biases in terms of addiction and pain management is media portrayal (Daniels, 2012; Hoffman et al., 2016). The media is compelling and plays a critical role in our unconscious mind more than we may want to believe. The media has repeatedly connected minorities to drug-abusing behaviors (Daniels, 2012; Hoffman et al., 2016). This factor proved to be one of many elements of the racial disparity in pain management (Daniels, 2012). As shameful as it may be to admit our unconscious biases, research has shown that healthcare providers perform these biases just as much as anyone else (Daniels, 2012; Sabrina & Greenwald, 2012).
The media, minorities, and drug abuse are common themes that displayed throughout America for years (Daniels, 2012; Taylor, 2008). Media outlets of all forms have long portrayed “addicts” or “dope boys” as ethnic minorities (Daniels, 2012; Taylor, 2008), and described blacks as more immoral and criminal than their white counterparts in news stories involving drugs (Taylor, 2008). Although the typical opioid addict was a white housewife, the media relentlessly placed the negative attention on black and Chinese men (Daniels, 2012; Taylor, 2008).
After the Mexican Revolution, the Mexican population grew in the southwestern part of the U.S., and the Mexican community was known for using marijuana recreationally (Valdez & Kaplan, 2019). They referred to marijuana as “mariguana” or “marihuana,” but the term was colonized to “marijuana” in order to be easily understood and translated in the English language – some consider marijuana to be a derogative term for this reason (Valdez & Kaplan, 2019). Marijuana began to grow in popularity, and this displeased a lot of racist people. In response, anti-immigration politicians began to portray Mexicans and marijuana together in a negative light. They warned Americans to beware of the “marijuana menace” who committed terrible crimes due to marijuana (Valdez & Kaplan, 2019). They also began to portray Mexicans as drug sellers who were selling “demon weed” or “locoweed” in the media (Valdez & Kaplan, 2019).
We can also look at the black community in which cocaine supposedly gave them “powers” that caused them to commit crimes and be unstoppable (Mejia, Beckermann, & Sullivan, 2018). Cocaine was once legal and used in quite a few everyday products. However, the criminalization of this drug had very racial undertones. A doctor by the name of Christopher Koch stated that most of the white women that reported attacks at this time were due to black people, and it was a result of their “cocaine-crazed” negro brain (Mejia et al., 2018). This belief began to become more popular for some reason as black people began to challenge segregation, voting laws, and civil rights in general. By the 1800s, almost all crimes committed by black people were assumed by government leaders to be related to the use of cocaine (Mejia et al., 2018).
This propaganda had been in all forms of media outlets for years, and although more subtle, it continues today. With criminalization, black people are likely to be on the news with nothing but a previous mugshot and a rap sheet that usually has drug convictions on them (Daniels, 2012). However, white people are displayed as coming from a loving family and having made a mistake (Daniels, 2012). They are also more likely to appear in treatment commercials, while minorities are likely to be on anti-drug propaganda (Daniels, 2012). We all have some form of implicit bias. I can admit that my brain subconsciously thinks white males when I hear the term “school shooter,” and that is because that is what I see in the media. Implicit biases can be limited when one is aware and willing to admit their own biases. However, when there is no training or acknowledgment, things such as racial disparities in pain management happen.
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