Black kids getting different emergency care for pain
A shocking new report out this week highlights a disparity in how black kids who receive emergency care for pain are treated differently than white children who get care for the same symptoms.
According to the study, published Monday in Pediatrics, black children are much less likely than white kids to be given painkillers when they show up in the emergency room complaining of stomach pain, cramps or spasms.
Based on data from more than 2,200 ER visits reviewed by researchers from Children’s Hospital of Philadelphia, study leaders found that white children and teenagers were more often given painkillers such as ibuprofen and acetaminophen or even more powerful opioids, including oxycodone than black kids. Researchers also noted that the difference in treatment remained the same regardless of the severity of a child’s condition.
In a statement to Reuter’s Health, Dr. Robert Fortuna, a health services researcher from the University of Rochester Medical Center whose own work has uncovered similar racial disparities in painkiller prescribing among adults said, “I don’t believe the vast majority of physicians knowingly or consciously treat patients differently. But, the bottom line is that minority children in this study were less likely to receive pain medications, and that’s concerning.”
One of the lead authors of the study, Dr. Tiffani Johnson said she believes the chaotic and stressful environment of an emergency room does not lend itself well for the establishment of physician-patient relationships. She and her colleagues believe this coupled with the subjective nature of stomach pain, may lead some doctors to use mental shortcuts, including stereotypes, when making treatment decisions.
Data was pulled from a national study that surveys hospitals about ambulatory care. The report included information from 2,298 patients ages 21 and younger who visited an emergency room between 2006 and 2009 with stomach pain, spasms or cramps.
Among children who noted severe pain—defined as a rating of seven or higher on a 10-point scale— 27 percent of white children were given some type of painkiller, compared to 16 percent of black kids and 19 percent of Hispanic children.
Across the board, black children were 39 percent less likely than their white counterparts to receive any painkillers, and 62 percent less likely to be given a narcotic in particular.
Another somewhat alarming finding was that both black and Hispanic youth were 60 to 70 percent more likely to spend more than six hours in the ER, compared to white children.
It’s important to note that researchers were not able to distinguish between the different underlying diagnoses that could have contributed to stomach pain, which may have influenced the results. Additionally, researchers say parental preferences regarding medication could have also played a role in the findings.
Experts say the results should trigger future research that looks into “system-level factors,” including the availability of primary care doctors, interpreters, specialists and pediatric formulations of painkillers in hospitals that serve different populations.
The researchers hope their findings will be used to develop and test interventions to target treatment differences. They say until that happens doctors need to be more aware of these disparities and make every effort to address pain control equally for all children.
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