New reporting from the Guardian has shed further light on the 'ethnicity pain gap', revealing that Black and Asian patients consistently receive inferior pain relief compared to white patients across multiple healthcare settings. Experts say the evidence is overwhelming: race and ethnicity are directly linked to differences in care quality and health outcomes.
Evidence of disparities in maternal and cancer care
In maternal care, women from Black and Asian backgrounds are less likely to receive an epidural during childbirth, even when they request one. Research indicates that Black women are stereotyped as having 'thick skin' and being able to tolerate more pain, while Asian women are seen as 'princesses' who are over-demanding. Similarly, in cancer treatment, patients from Black, South Asian, and mixed ethnic backgrounds received fewer and lower doses of pain-relieving medications than white patients, after controlling for age, cancer type, health condition, deprivation, and other variables.
Systemic solutions beyond accusations of racism
According to Prof Devi Sridhar, chair of global public health at the University of Edinburgh, calling people racist generally does not help address these inequalities, as it can lead to defensiveness. Instead, she advocates for four evidence-based interventions. First, healthcare organisations should routinely collect and transparently share racial and ethnic disparity data, as 'what gets measured gets prioritised and improved'. Second, awareness-raising for all staff about unconscious biases can dispel myths such as that Black patients have higher pain tolerance or that Asian patients have lower tolerance. Third, standardised clinical pathways—checklists, protocols, and objective criteria—reduce individual bias in medical decisions. Finally, leadership from the top must recognise the ethnicity pain gap and make it a priority across the organisation.
Changing culture for fairer healthcare
Prof Sridhar emphasises that none of this is about accusing individual staff of racism. Most healthcare workers genuinely want to provide the best care possible, but data shows a clear pattern of racial and ethnic differences. Acknowledging the evidence is the first step toward collective solutions. She concludes that patients should receive the same high-quality care regardless of skin colour, calling it 'simply good healthcare and good practice'.
