Racialized bias in pediatric pain: the role of observers’ attentional processing and estimations of children’s pain

Background: Research demonstrates racism in pediatric pain care. However, the mechanisms underlying these injustices are not well understood. This study examined White observers’ attentional processing of facial expressions of pain demonstrated by White vs. Black children and observers’ estimations of the pain expressiveness levels of these children. Furthermore, we assessed whether differences in observers’ attentional processing were influenced by observers’ pain beliefs and the pain expressiveness level. Method: Eighty White adults (42 women; 38 men) performed the visual search task (VST), rated the levels of pain that the children expressed, and reported their beliefs concerning the pain experience of White vs. Black children. Results: Findings revealed facilitated attentional engagement towards Black compared to White child pain faces, particularly at high pain expressiveness levels. No attentional disengagement effects were observed. Pain estimations increased with increasing pain expressiveness but, contrary to prior findings, did not differ for White vs. Black children. Observers’ false pain beliefs did not significantly impact their attentional processing nor pain estimations. Conclusions: The results underscore the importance of understanding how racialized disparities in observers’ attentional processing of others’ pain may contribute to racialized inequities in pediatric pain care.