Pain and Prejudice: The Influence of Socioeconomic Cues on Pain Assessment

Abstract

In the United States, people of low socioeconomic status (SES) struggle to access quality healthcare. Healthcare workers’ implicit biases impact the quality of healthcare, so examining these biases could lead to improvements that may lessen the inequities faced by poor patients. The thick skin bias refers to people’s tendency to perceive the disadvantaged as less affected and pained by adverse events. One natural interpretation of the bias attributes it to the impression that the poor have experienced more disadvantageous experiences and have thus developed “thick skin”. The literature has found this bias to be considerable in physicians towards black patients and women, but has not been specifically studied in the context of healthcare towards poor patients. This thesis asks: do cues about a person’s SES affect how others perceive their pain? To examine this, we use an online survey in which participants viewed images of people in pain, in either a rich or poor environment, and rated how much pain they believe the person to be in on a Likert scale. The hypothesis driving this research is that participants would rate the people in the poor environment to be in less pain. While the results did not show statistically significant differences, future research should examine these biases with a larger participant pool and more advanced stimuli.