Modern racism contributes to overall less pain management and a "one size fits all" approach.

Background: Black, Latine, and Asian patients report higher levels of pain and experience more pain treatment disparities compared to White patients. Providers' modern racism might lessen the attention to such disparities and therefore affect how they manage pain. The aim of this study was to identify differences in pain management among participants high vs. low in modern racism and who vary in racial and gender identity according to race and gender of the patient.

Participants and procedure: Participants (N = 762) were purposefully sampled on Prolific, a crowdsourcing website, to vary in race (White, Black, Asian, Native Hawaiian/Pacific Islander, Multiracial) and gender (cisgender men, cisgender women, transgender men, transgender women, nonbinary, genderqueer, agender, two-spirit, gender nonconforming, multiple genders). In a cross-sectional survey study, participants were randomly assigned to read 20 hypothetical emergency medicine vignettes of acute injuries that varied by patient race (White, Black, Latine, and Asian) and patient gender (cisgender woman, cisgender man, nonbinary, transgender woman, transgender man). Participants rated the extent of pain management for each vignette. Participants self-reported modern racism.

Results: Participants low in modern racism provided more pain management to Black patients than all other groups, while participants high in modern racism provided similar amounts of pain management to all racial groups, but less pain management overall. In addition, among White participants, men prescribed less pain management to Black patients than women.

Conclusions: The results suggest that modern racism predicts racial disparities in pain management in addition to participant gender and racial identity.