A study published yesterday in Jama Pediatrics found that doctors are less likely to give black children painkillers in the emergency room than their white peers—even when they are suffering from agonizing conditions.

The report, “Racial Disparities in Pain Management of Children With Appendicitis in Emergency Departments,” found that across all backgrounds, 57 percent of children who arrived in the ER with acute appendicitis were given pain medication. Despite the fact that experts agree that appendicitis is a condition that requires opioids (such as fentanyl and morphine) for pain relief, just 41 percent of the children received them. That already-low number drops off precipitously when it comes to black children: Only 21 percent were given opioids, versus 43 percent of white patients. Overall, the researchers found that black kids with acute appendicitis only have a 12.2-percent chance of receiving proper pain management. 

To uncover these statistics, the researchers—led by Monika K. Goyal of the Children’s National Health System—examined National Hospital Ambulatory Medical Care Survey data from 2003 through 2010, which revealed the treatment plans for about 940,000 children who suffered acute appendicitis in that time period. The researchers concluded that the unequal treatment can be attributed to racial bias and an unfounded fear of administering the powerful opioids to children.

“Our findings suggest that there are racial disparities in opioid administration to children with appendicitis,” the study concluded. “Our findings suggest that although clinicians may recognize pain equally across racial groups, they may be reacting to the pain differently by treating black patients with nonopioid analgesia, such as ibuprofen and acetaminophen, while treating white patients with opioid analgesia for similar pain.”

A 2011 study found that white people do not feel the same level of empathy for black people experiencing physical pain that they do for people of their own race. And other studies have uncovered racial bias in medical care for people of color. It’s a phenomenon so widespread that the government’s Healthy People 2020 initiative counts eliminating that health inequity as one of its goals.