Understanding the Pain Gap for So Many Who Suffer

Though methods for assessing and reporting pain exist, as discussed in one of our posts from last January, many medical professionals struggle to objectively treat and identify the severity of patients’ pain levels. Unfortunately, disparities in treatment are due not only to individual judgment, but are also connected to the cost and availability of medication and the biases held by medical professionals across the world. In this post we will highlight three of those barriers keeping everyone from access to the pain treatment they deserve:


Limited access and high cost

One of the most widespread challenges to providing relief for pain is the cost of pain medication in many countries. In one study that analyzed data from 172 countries, 83% of the 61 million people enduring physical or psychological suffering live in low- and middle-income countries where there is little or no access to low-cost morphine.[1] With only 3.6% of the world’s oral morphine distributed to low- and middle-income countries, pain medication is not only less accessible, but over five times the cost per 10-milligram dose in these countries.[2] Despite the fact that $100 billion a year is spent worldwide by governments to enforce drug prohibition, the drugs that are needed aren’t made available.[3]


Biases towards female patients

Half the population is likely aware of the fact that female pain is serially misdiagnosed. Particularly in emergency settings, it has been found that women are more likely to have their pain described as emotional or psychogenic and therefore not be treated with the pain medications typically given to their male counterparts.[4] Despite the fact that women are more likely to report pain then men, their complaints are more likely to be dismissed and their persistence is less likely to be taken seriously.[5] One study found that women were half as likely as men to receive pain killers after having surgery because health care professionals are taught to more conservatively dispense narcotics to expressive patients – stereotypically associated with females – and more liberally to stoical patients – stereotypically associated with men.[6]


Biases towards people of color

The U.S. medical system has a long history of disregarding the pain of patients of color. Sometimes this is due to blatant racism, and sometimes it occurs because a clinician doesn’t realize how cultural differences can affect how an individual expresses pain.[7] Black people in particular have been negatively affected by prevalent stereotypes in the medical community. For example, a 2016 study determined that many white laypeople and medical students still hold false beliefs about biological differences between white and black patients that predict racial bias in pain perception and treatment.[8] Beliefs that black people have “thicker skin” or are in general more tolerant of pain along with common assumptions that black patients are more likely to be drug addicts keep many clinicians from prescribing necessary pain medications.[9] This has resulted in the fact, confirmed by multiple studies, that black patients are half as likely to receive pain medication as white patients.[10]


Pain is part of the human experience, but unjustly ignored pain shouldn’t have to be.


Attorneys understand issues of pain, especially when working with clients who have endured pain and suffering as the result of injury from others. As legal nurses, we might not be able to help your client in their pain management; we can however assist you with the presentation of their pain and suffering for litigation. Give us a call and see how we can provide the needed support to your practice.



[1] Preidt, Robert, “Around the World, Too Little Relief for Pain,” HealthDay News, Oct. 2017, https://consumer.healthday.com/general-health-information-16/misc-drugs-news-218/around-the-world-too-little-relief-for-pain-727396.html

[2] Ibid

[3] Ibid

[4] Boynes-Shuck, Ashley, “Is There a Gender Bias Against Female Pain Patients?” Healthline, Jan. 31, 2017,  https://www.healthline.com/health-news/gender-bias-against-female-pain-patients#1

[5] Schopen, Fay, “The healthcare gender bias: do men get better medical treatment?” The Guardian, Nov. 20, 2017, https://www.theguardian.com/lifeandstyle/2017/nov/20/healthcare-gender-bias-women-pain; Boynes-Shuck, “Is There a Gender Bias”

[6] Fenton, Siobhan, “How Sexist Stereotyes Mean Doctors Ignore Women’s Pain,” The Independent, July 27, 2016, http://www.independent.co.uk/life-style/health-and-families/health-news/how-sexist-stereotypes-mean-doctors-ignore-womens-pain-a7157931.html

[7] Holpuch, Amanda, “Black patients half as likely to receive pain medication as white patients, study finds,” The Guardian, Aug. 10, 2016, https://www.theguardian.com/science/2016/aug/10/black-patients-bias-prescriptions-pain-management-medicine-opioids

[8] Hoffman, Kelly M., Trawalter, Sophie, Axt. Jordan R., & M. Norman Oliver, “Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites,” National Institutes of Health, April 19, 2016, https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&cad=rja&uact=8&ved=0ahUKEwiBneaV7djYAhUi5IMKHdLOAvsQFgg6MAM&url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4843483%2F&usg=AOvVaw3ouZ1LYOb7ydx6oTRkoLr2

[9] Holpuch, “Black patients half as likely”; Wailoo, Keith, “The Pain Gap: Why Doctors Offer Less Relief to Black Patients,” The Daily Beast, April 11, 2016, https://www.thedailybeast.com/the-pain-gap-why-doctors-offer-less-relief-to-black-patients

[10] Holpuch, “Black patients half as likely”