Study Shows Continuing Disparities in Health Care

January 3, 2008 -- In a 13-year study examining 150,000 emergency room visits, doctors were found more likely to prescribe strong narcotics to patients complaining of pain than in the past, yet less likely to prescribe them to minorities than to white patients. The study, appearing in the Journal of the American Medical Association (JAMA), said that this was the case even when patients complained of severe pain such as with kidney stones.

From 1993 to 2005, prescriptions of narcotics for pain relief in emergency rooms rose from 23 percent to 37 percent overall. This increase appears to be the result of changing attitudes among doctors who now view pain management as a key part of the healing process. However, the study found that opioid narcotics were prescribed in 31 percent of pain-related ER visits involving whites, 28 percent involving Asians, 24 percent involving Hispanics, and 23 percent involving blacks. In more than 2,000 visits for kidney stones, whites were given narcotics 72 percent of the time, Hispanics 68 percent, Asians 67 percent, and blacks 56 percent.

The Institute of Medicine report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care said that racial and ethnic minorities tend to receive lower-quality health care than whites do, even when insurance status, income, age, and severity of conditions are comparable. It recommends first and foremost to increase awareness about racial and ethnic disparities in health care among the general public, health care providers, insurance companies, and policymakers. Consistency and equity of care also should be promoted through the use of "evidence-based" guidelines to help providers and health plans make decisions about which procedures to order or pay for based on the best available science.

• Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care

• JAMA Acute Pain Treatment Webpage