The researchers also found that minorities had longer emergency department waiting times and were less likely to be admitted to the hospital. They also found that in hospitals treating the largest proportion of minorities and the largest proportion of patients with severe pain, minorities were at particularly high risk for inadequate treatment of pain.

The researchers offer some possible explanations for these points: longer wait times may partially be explained by language barriers that make it difficult for patients to communicate their concerns effectively. Since the researchers found no disparities in the number of diagnostic and screening procedures administered, it is possible that longer ED stays could be for logistical reasons,however, their analysis cannot confirm this hypothesis.

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The stressful environment of EDs frequently necessitates that clinicians make decisions based on heuristics when they are under pressure and have limited information. Stereotypes and racial biases have been shown to influence decisions in these situations.

“These findings add to the overwhelming evidence that racial/ethnic disparities not only exist, but are unfortunately endemic in health care settings,” said Dr. Haider in a press release. “It is essential that we as a medical community work to ensure that every patient receive unbiased empathy and the highest standard of care, regardless of his/her racial heritage.”

The researchers note that to determine the extent of these occurrences, additional research is needed to examine the root causes of disparities among providers. Future studies should also examine whether there are EDs or aspects of ED care in which race or ethnicity doesn’t play a role, and in these cases, what factors do come into play in deciding whether to prescribe pain medications.


Shah AA, Zogg CK, Zafar SN, et al. Analgesic Access for Acute Abdominal Pain in the Emergency Department Among Racial/Ethnic Minority Patients: A Nationwide Examination. Medical Care. 2015; doi: 10.1097/MLR.0000000000000444.