Seeing No Pain: Assessing the Generalizability of Racial Bias in Pain Perception

Racial disparities in pain care may stem, in part, from perceptual roots. It remains unresolved, however, whether this perceptual gap is driven by general deficits in intergroup emotion recognition, endorsement of specific racial stereotypes, or an interaction between the two. We conducted four experiments (total N = 635) assessing relationships between biases in pain perception and treatment and biases in the perception of anger, happiness, fear, and sadness. Participants saw Black and White male targets making increasingly painful and angry (Experiment 1), happy (Experiment 2), fearful (Experiment 3), or sad expressions (Experiment 4). The effect of target race consistently varied based on the emotion displayed. Participants repeatedly saw pain more readily on White (vs. Black) male faces. However, while participants also saw sadness less readily on Black faces, perception of anger. fear, and happiness did not vary by target race. Moreover, the tendency to see pain less readily on Black faces predicted similar differences in recognizing (particularly negative) expressions, though only racial bias in pain perception facilitated similar biases in treatment. Finally, while endorsement of racialized threat stereotypes facilitated recognition of angry expressions and was marginally associated with impeded recognition of happy expressions on Black faces, gaps in pain perception were not reliably related to stereotype endorsement. These data suggest that while racial bias in pain perception is associated with a general bias in recognizing negative emotion on Black male faces, the effects of target race on pain perception are particularly robust and have distinct consequences for gaps in treatment.

Automated summary

Racial bias in pain perception is associated with a general bias in recognizing negative emotion on Black male faces, but the effects of target race on pain perception are particularly robust and have distinct consequences for gaps in treatment. However, endorsement of racialized threat stereotypes does not reliably affect gaps in pain perception.