Patients from minority ethnic backgrounds are consistently overlooked when it comes to having their pain acknowledged and treated in UK healthcare settings. A growing body of research reveals that these disparities affect people's lives from childhood to end-of-life care, with minority patients often facing a double burden: not only do they experience more intense pain before being taken seriously, but they also receive less effective treatment compared to their white counterparts.
Research has shown that in paediatric settings, children from minority ethnic backgrounds are often required to display stronger expressions of pain before it is recognised. A 2024 study by academics at the University of Delaware found racial bias in paediatric pain perception, where participants were less likely to perceive and treat pain in Black children compared to white boys. This suggests an underlying bias that can influence treatment decisions.
A 2020 study led by Monika Goyal of the Children's National Hospital in Washington also highlighted disparities in pain management for children with fractures in US emergency departments. The research found that minority children were more likely to receive basic analgesics but significantly less likely to be given opioids, even after adjusting for injury severity and pain intensity.
Similar disparities have been observed in other paediatric conditions, such as appendicitis, where Black children are 80% less likely to receive opioids for severe pain than their white counterparts. A 2024 study from University College London also found that Black children are at four times greater risk of experiencing post-surgical complications, including severe pain.
The ethnicity pain gap extends into maternity care, an area where disparities have been well-documented. Research indicates that Black women are almost twice as likely to have their births investigated for safety failings compared to white women and remain three times more likely to die during childbirth. An interim report by the National Maternity and Neonatal Investigation highlighted accounts of Asian women being stereotyped as 'princesses' and Black women being perceived as having a higher pain tolerance, leading to their complaints of pain being dismissed.
Dr Sarah Marsh, a specialist in maternal health at Barts Health NHS Trust, notes that these findings are not surprising given the systemic issues within the healthcare system. She stresses that addressing this disparity requires a multifaceted approach, including targeted education and training for healthcare professionals to better understand and address the needs of minority patients.
The UK's National Institute for Health and Care Excellence (NICE) has acknowledged these disparities and is working with healthcare providers to develop more inclusive pain management strategies. However, experts warn that tackling this issue will require sustained commitment from policymakers and a fundamental shift in how pain is perceived and treated across all healthcare settings.
A spokesperson for NHS England stated: "We are committed to addressing health inequalities and ensuring that patients receive high-quality care regardless of their background. We are working closely with healthcare providers and partners to develop targeted strategies to address the ethnicity pain gap."