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The Unique and Interactive Effects of Patient Race, Patient Socioeconomic Status, and Provider Attitudes on Chronic Pain Care Decisions
- Source :
- Ann Behav Med
- Publication Year :
- 2020
- Publisher :
- Oxford University Press (OUP), 2020.
-
Abstract
- BackgroundCompared to White and high socioeconomic status (SES) patients, Black and low SES patients receive less adequate pain care. Providers may contribute to these disparities by making biased decisions that are driven, in part, by their attitudes about race and SES.PurposeWe examined the effects of patient race and SES on providers’ chronic pain decisions and the extent to which providers’ implicit and explicit attitudes about race and SES were related to these decisions.MethodsPhysician residents/fellows (n = 436) made pain care decisions for 12 computer-simulated patients with chronic back pain that varied by race (Black/White) and SES (low/high). Physicians also completed measures assessing implicit and explicit attitudes about race and SES.ResultsThere were three significant race-by-SES interactions: (a) For high SES patients, Black (vs. White) patients were rated as having more pain interference; the opposite race difference emerged for low SES patients. (b) For high SES patients, Black (vs. White) patients were rated as being in greater distress; no race difference emerged for low SES patients. (c) For low SES patients, White (vs. Black) patients were more likely to be recommended workplace accommodations; no race difference emerged for high SES patients. Additionally, providers were more likely to recommend opioids to Black (vs. White) and low (vs. high) SES patients, and were more likely to use opioid contracts with low (vs. high) SES patients. Providers’ implicit and explicit attitudes predicted some, but not all, of their pain-related ratings.ConclusionThese results highlight the need to further examine the effects of patient race and SES simultaneously in the context of pain care.
- Subjects :
- Adult
Male
Attitude of Health Personnel
Clinical Decision-Making
Pain Interference
Context (language use)
Race (biology)
Back pain
Humans
Pain Management
Medicine
Socioeconomic status
General Psychology
business.industry
Chronic pain
social sciences
medicine.disease
Race Factors
Psychiatry and Mental health
Distress
Social Class
Interactive effects
population characteristics
Female
Chronic Pain
medicine.symptom
business
Prejudice
Regular Articles
Clinical psychology
Subjects
Details
- ISSN :
- 15324796 and 08836612
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Annals of Behavioral Medicine
- Accession number :
- edsair.doi.dedup.....8abaa669870a05660ce1e60cd4dc1294