Here at We ❤️ Health Literacy Headquarters, we’re always looking for new ways to center equity in health communication. And today, we want to focus on one type of equity that’s been getting some much-needed attention: pain equity.
You may have seen news recently about how our health care system often fails to treat pain in women and people of color. (Whether it’s trending in your TikTok feed via #IUD or brought to you by the makers of a well-known OTC pain reliever.) So we looked at some examples of how pain inequity affects these groups.
First up: the long history of racial pain bias. False beliefs that Black people felt less pain were once used to legitimize doing medical experiments on enslaved people without anesthesia. But even today, doctors tend to both underestimate and undertreat Black patients’ pain across the lifespan, whether treating a child with appendicitis or an older adult with terminal cancer.
For people with sickle cell disease, most of whom are Black, stigma around drug-seeking limits access to the opioids they often need to control a pain crisis. And for Black people who give birth, racism and bias in the health care system means not only a higher risk of dying in childbirth, but a lower chance of getting adequate care for postpartum pain.
That brings us to the gender pain gap. When women and other people assigned female at birth seek pain relief for periods or childbirth, they often come up against societal beliefs that this pain is inevitable. And this inequity isn’t just a pain in the uterus. Women have higher rates of chronic pain in general, but often report that doctors dismiss the severity of their pain or fail to treat it appropriately. That is, if doctors believe they’re in pain at all — see the recent case where a nurse at a fertility clinic replaced fentanyl drips with saline, and doctors ignored the dozens of women who said they felt every agonizing moment of their egg retrieval procedures.
The harms of all this untreated and disbelieved pain go far beyond the sensation itself (though that’s harmful enough!). Chronic pain causes problems with sleep, mental health, and many other parts of daily life. And when doctors don’t take acute pain seriously, it can delay diagnosis for life-threatening conditions. For example, when women and people of color go to the emergency department with chest pain, they often wait longer to get checked for a heart attack.
So what’s a health communicator to do? We may not be able to waive a magic wand and deliver equitable pain care for all. But we can help fill the gaps in pain-related health content. Try these tips:
- Validate that the pain is real. When you’re writing about a painful health condition, it can be tempting to downplay the pain part. But your audience may already feel that no one believes them. So don’t sugarcoat the situation — say clearly that the condition causes pain and explain how severe it may be.
- Offer tips for self-advocacy. Of course, the burden of advocating for equitable pain care shouldn’t fall on the people in pain. But it’s still helpful to share practical advice for how to prepare for a health care visit related to pain or for how to describe your pain to your doctor.
- Beware of implicit bias. You may be thinking, “hey, I just read a whole blog post about equity, my mind is now a bias-free paradise, pal!” But the tricky thing about this kind of bias is that it’s unconscious. So we all need to continuously examine the choices we make in creating health content — and weed out the sneaky biased bits.
- Consider how pain affects health literacy (which is, as we like to say, a state, not a trait). Remember that being in pain can negatively affect your audience’s ability to find, understand, and use health information. All the more reason to test content early and often with people who are living with pain, so they can tell you if you’re getting it right.
The bottom line: Pain equity is an important part of the health equity conversation. As health communicators, we can do our part to help everyone get the pain management care they need.
Copy/paste to share on social (and tag us!): How can health communicators help promote equity in pain management? Try these tips from CommunicateHealth: https://communicatehealth.com/wehearthealthliteracy/bridging-the-pain-gap/ #DEI #HealthComm #HealthLiteracy
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