Black Youth and Caregiver Experiences of Racism in Pain Management: A Narrative Inquiry

Black communities face high rates of unmanaged pain due to anti-Black racism in the healthcare system. However, a gap currently exists in the understanding of how anti-Black racism impacts pain management conversations (ie where a pain management plan is discussed with a healthcare professional) with youth in Canada. The purpose of this study was to gain a rich understanding of the experiences of anti-Black racism in a group of Black youth and their caregivers who had pain management conversations with healthcare professionals.

A qualitative narrative inquiry study, an approach well-suited to centering participant voices, was conducted through interviews with five Black caregiver-youth dyads (youth 12-18 years, M = 14.5 years; caregivers M = 46.8 years; ten participants total) using open-ended questions and prompts to explore how anti-Black racism impacted youths' pain management experiences. Caregiver accounts were used to further contextualize the youths' narrated experiences. Data were analyzed through thematic narrative analysis to identify common themes in their stories of pain management conversations.

Two overarching themes were generated from the interviews: "The Healthcare System Rendering Black Youth as Invisible" and "Healthcare Professionals Dismissing Black Youth". The first theme captured how Black youth and their caregivers had often felt ignored within healthcare settings, particularly through adultification and the normalization of inequitable pain care. The second theme reflected how participants had been emotionally invalidated, overlooked, and felt forced to advocate for themselves or their youth due to inadequate support and communication from healthcare providers and intergenerational experiences of anti-Black racism within health contexts.

These findings provide nuanced insights into the pain management experiences of a group of Black youth and caregivers, centering their voices and lived realities.