A new study provides evidence that lower-class individuals are stereotyped as insensitive to physical pain, which could impact their medical care and treatment recommendations. The findings have been published in the Journal of Experimental Social Psychology.
“National health statistics indicate that wealthy people receive more substantial pain treatment than poor people. In this work, we aimed to better understand how stereotypes might contribute to such socioeconomic (SES) based disparities in healthcare,” said study author Kevin Summers, a graduate student at the University of Denver and member of the Lloyd Social Detection Lab.
“Much of the previous work seeking to better understand factors that may underlie these pain disparities had focused on structural-level (e.g., lack of access to quality care or insurance) and patient-level (e.g., adherence to treatment regimens, exercise, smoking and alcohol use) factors. Yet, little work had focused on potential perceiver-level biases (e.g., providers’ stereotypes or biases) that might aid in explaining treatment disparities.”
“Our research team has expertise in understanding how perceiver-level biases may influence real-world disparities, and thus we took this lens to better understand the relative undertreatment of low-SES individuals’ pain,” Summers explained.
Across 10 experiments, with 1,584 participants in total, the researchers consistently found that poor people were perceived as experiencing less pain.
The researchers found that individuals with low-paying jobs (such as being a dishwasher) were viewed as being less sensitive to pain than individuals with high-paying jobs (such as being a doctor.) In addition, an imagined individual who was explicitly described as being low in socioeconomic status was perceived as being less sensitive to pain compared to an imagined individual who was high in socioeconomic status.
“We found that our pain sensitivity effects generalized across judgments of both White and Black individuals and men and women,” Summers said.
The researchers also found a potential mechanism underlying these biased perceptions of pain sensitivity. Poor individuals were assumed to have experienced more hardships in life compared to their wealthy counterparts, which in turn was associated with reduced perceptions of pain sensitivity. In other words, people appear to believe that hardship “toughens up” individuals who are low in socioeconomic status.
Biased perceptions of pain sensitivity also appeared to have worrisome downstream consequences. Summers and his team found that participants viewed poor individuals as requiring less treatment than their wealthy counterparts to relieve pain caused by various different injuries. This effect was even observed among a sample of medical providers.
“This work has clear implications for medical personnel and lay people alike. In medical settings, beliefs about how hard a low-SES compared to high-SES individual’s life has been may influence perceptions of how much pain that individual feels and therefore may contribute to disparate pain treatment outcomes across socioeconomic status,” Summer told PsyPost.
“However, the implications are not limited to the healthcare setting. Simply knowing a friend’s or stranger’s socioeconomic status (which research suggests can readily be inferred from subtle verbal and nonverbal cues) may influence how much pain is attributed to them and therefore how much support is offered. For example, a passerby may ignore a low-SES stranger who fell on the sidewalk, a friend may suggest that a lower-SES friend just ‘deal with’ an injury rather than seek medical attention, a boss may give less time-off or paid compensation to a lower-SES injured employee.”
“In short, stereotypes about how hard low- vs. high-SES individuals’ lives have been may have important consequences for perceptions of pain sensitivity and therefore may contribute to disparate treatment outcomes in healthcare domains and beyond,” Summers said.
But the study — like all research — includes some caveats.
“We found that perceivers judged low-SES people as less sensitive to pain and as requiring less treatment than high-SES people in a lab setting, however, it is still imperative to address how these perceiver biases play out in a clinical setting. Our findings align with medical research suggesting that lower-class patients are undertreated relative to higher-class patients, but we cannot say with absolute certainty that stereotypes of life hardship and pain sensitivity underlie these findings from the medical literature,” Summers explained.
“Future work should examine whether medical providers’ stereotypes and beliefs concerning the relationship between patients’ SES and their pain sensitivity influence disparate treatment decisions in a doctor’s office rather than a lab setting.”
“Our lab is continuing this line of work to investigate whether perceptions of low-SES individuals as less sensitive to pain than high-SES individuals also extends to judgments of children. Thus far, we have found very similar effects in judgments of low-SES children which we believe highlights just how pervasive these SES-based stereotypes may be,” Summers added.
The study, “Poverty and pain: Low-SES people are believed to be insensitive to pain“, was authored by Kevin M. Summers, Jason C. Deska, Steven M. Almaraz, Kurt Hugenberg, and E. Paige Lloyd.
