Previous work demonstrates that racial disparities in pain care may stem, in part, from perceptual roots. It remains unresolved, however, whether this perceptual gap is driven by general deficits in intergroup emotion recognition, endorsement of specific racial stereotypes, or an interaction between the two. We conducted four experiments (total N = 635) assessing relationships between biases in pain perception and treatment with biases in the perception of anger, happiness, fear, and sadness. Participants saw Black and White targets making increasingly painful and angry (Experiment 1), happy (Experiment 2), fearful (Experiment 3), or sad expressions (Experiment 4). The effect of target race consistently varied based on the emotion presented. Participants consistently saw pain more readily on White (versus Black) faces. However, while the perception of sadness was also disrupted on Black faces, the perception of anger, fear, and happiness did not vary by target race. Moreover, the tendency to see pain less readily on Black faces predicted similar disruptions in recognizing (particularly negative) expressions, though only racial bias in pain perception facilitated similar biases in treatment. Finally, while endorsement of racial stereotypes about threat facilitated recognition of angry expressions and impeded recognition of happy expressions on Black faces, gaps in pain perception were not reliably related to stereotype endorsement. These data suggest that while racial bias in pain perception is associated with general disruptions in recognizing negative emotion on Black faces, the effects of target race on pain perception are particularly robust and have distinct consequences for gaps in treatment recommendations.
Perceptual factors underlie the underestimation bias in pain perception of black and white faces
