A Call to Study the Bidirectional Relationship Between Healthcare Accessibility Issues and Medical Gaslighting for Marginalized Groups with Chronic Pain

Chronic pain is an epidemic in its own right. Affecting 21% of American adults and costing $300 billion each year, chronic pain rivals cancer, diabetes, and hypertension combined. From psychological impacts on patients to worsening health outcomes further burdening the healthcare system and billions of lost productivity stressing the economy, chronic pain can affect all Americans. However, chronic pain disproportionately afflicts marginalized groups including non-whites, women, and disadvantaged socioeconomic classes. For decades, research has demonstrated disparities in diagnosis, treatment, and management of chronic pain are associated with accessibility issues in healthcare, a link that is likely the result of systemic discrimination. More recently, the inequality of care for disparaged patients has also been connected to a psychological phenomena freshly coined as “medical gaslighting.” Medical gaslighting can include minimization of pain symptoms, paternalism, and even dismissal of physical disease. Despite the popularity of both topics in research, the potential relationship between accessibility and medical gaslighting has never been studied. Given that both greatly affect disadvantaged populations on an individual level, within the healthcare system, and the overall economy, their contributions to the systemic problems pervasive throughout medicine should be better understood. Ending the bidirectional relationship between accessibility and medical gaslighting is one large step toward ending health inequalities.