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Unequal Pain Relief In The Emergency: Racial Bias?

 
 
Miller
 
Reply Tue 1 Oct, 2013 10:35 am
September 30, 2013, 10:19 am
Unequal Pain Relief in the Emergency Room

By NICHOLAS BAKALAR

Black and Hispanic children who go to an emergency room with stomach pain are less likely than white children to receive pain medication, a new study reports, and more likely to spend long hours in the emergency room.

The analysis, published in the October issue of Pediatrics, examined the records of 2,298 emergency room visits by people under 21, a nationally representative sample from a large survey conducted by the Centers for Disease Control and Prevention. About 53 percent were white, 24 percent non-Hispanic black, 21 percent Hispanic, and the rest from other ethnic or racial groups.

Over all, 27.1 percent of white children with severe pain received analgesics, but only 15.8 percent of blacks, 18.9 percent of Hispanics and 7.1 percent of children of other races did.

Black children were about 68 percent more likely than white children to spend longer than six hours in the emergency room, although there were no statistically significant differences among races in results for any diagnostic test.

“This data set will not answer the question of why,” said the lead author, Dr. Tiffani J. Johnson, an instructor at the University of Pennsylvania School of Medicine. “It could be that white parents are more likely to ask for pain meds, or that minority patients are likely to get care in E.R.’s that have longer wait times. And it could be racial bias.”
NYTimes.com
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Type: Discussion • Score: 1 • Views: 1,540 • Replies: 10
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contrex
 
  1  
Reply Tue 1 Oct, 2013 11:27 am
@Miller,
Miller wrote:
This data set will not answer the question of why,” said the lead author [...] “It could be that white parents are more likely to ask for pain meds, or that minority patients are likely to get care in E.R.’s that have longer wait times. And it could be racial bias.”

Your title kind of cherry picks, doesn't it? Shouldn't it be "Unequal Pain Relief In The Emergency: Pushy White Parents, Crowded ERs or Racial Bias?"
0 Replies
 
contrex
 
  1  
Reply Tue 1 Oct, 2013 03:46 pm
Or could cost be a factor? Do American parents have to pay for medicines for kids in hospitals?
roger
 
  1  
Reply Tue 1 Oct, 2013 05:58 pm
@contrex,
They are billed for them, and everything else. How often payment is received is a separate issue.
0 Replies
 
Miller
 
  1  
Reply Wed 2 Oct, 2013 09:45 am
@contrex,
contrex wrote:

Or could cost be a factor? Do American parents have to pay for medicines for kids in hospitals?


The main issue, as far as I can tell is really the difficulty in the communication department among different ethnicities.
contrex
 
  1  
Reply Wed 2 Oct, 2013 10:10 am
@Miller,
Miller wrote:

The main issue, as far as I can tell is really the difficulty in the communication department among different ethnicities.


Do explain a little what you mean by this.
Miller
 
  1  
Reply Wed 2 Oct, 2013 10:17 am
@contrex,
Pain is assessed ( or at least it should be) very differently in a child as opposed to an adult. Usually a number scale is used with adults, while with children pictures of faces are usually presented to kids.

Children may have a hard time defining what "pain" means to them. Likewise with adults.

In the ER, time is short for treatment . If the child can not express himself well , or is afraid of the hospital environment, he/she mightnot receive the proper amount of pain medication to ease his/her suffering.

Language is also another problem, especially in the ER , where again, time is of the essence and good communication between patient, patient's family and the physician/nurse is critical.
contrex
 
  1  
Reply Wed 2 Oct, 2013 11:41 am
@Miller,
Miller wrote:

Pain is assessed ( or at least it should be) very differently in a child as opposed to an adult. Usually a number scale is used with adults, while with children pictures of faces are usually presented to kids.


Well, yes, I was wondering about this too. Also, when I was a boy I was expected to "be a brave soldier" whereas my sister used to scream the house down over every little nick and scratch. (I never pushed her. Honest.)

Miller
 
  1  
Reply Sun 6 Oct, 2013 09:39 am
@contrex,
In the hospital, I've found that men complain the most. I don't know why, unless they just want attention.
0 Replies
 
Kolyo
 
  1  
Reply Sun 6 Oct, 2013 09:43 am
@Miller,
Miller wrote:

Over all, 27.1 percent of white children with severe pain received analgesics, but only 15.8 percent of blacks, 18.9 percent of Hispanics and 7.1 percent of children of other races did.


It's probably a cultural thing. The little white brats just whined louder, I'll bet. Laughing

What's the saying? The squeaky wheel gets the grease.
Miller
 
  1  
Reply Sun 6 Oct, 2013 09:49 am
@Kolyo,
No mention of Asian kids expressing pain. But I'd speculate that these kids are told to "suck it up" by their parents and keep a stiff upper chin. Interesting, Asian-American adults have a "fear" of blood... or it it just the needle?
0 Replies
 
 

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