Category: Health care

September 2024: Working towards more just futures

“It is certain, in any case, that ignorance, allied with power, is the most ferocious enemy justice can have”

(James Baldwin, 1972, p. 149). No name in the street. New York: The Dial Press.

Marcia

Welcome to the 2024-2025 academic year. I’m really proud of the work across Indigenous health, social justice and anti-racism, and the ongoing efforts to contribute to more culturally safe and racially just outcomes. Dr. Douglas continues to provide leadership in developing new educational initiatives to enhance the racial literacy of the Rady community.

Working with the Offices of Equity, Access and Participation, and Community Engagement and Social Accountability, the new dialogue series will align with the Faculty strategic priority of reciprocal  community engagement and build from passive receipt of knowledge to active dialogue. These offices provide excellent educational resources to our community, but it is up to each of us to apply that knowledge in our work and learning environments.

This year I encourage you to reflect regularly on how you can take the new things you learn, and apply this new knowledge in meaningful ways that result in more culturally safe and anti-racist environments for our increasingly diverse community. It is through your individual and collective actions that positive change will happen.

Delia

September greetings! A new academic year is upon us and as part of our commitment in working towards more just futures we will be launching a number of initiatives that we want to tell you about.

Here Come the Modules:

Foundations of Race, Racism, and Anti-Racism

This online module is one mechanism that builds on the Disruption of All Forms of Racism Policy by providing people with a resource to cultivate their racial literacy.

I understand that people come to this material from different vantage points. This module is an opportunity to expand our understanding of the meaning and significance of race and the persistence of racism because to combat racism in its various forms, we must first understand it.

You cannot get to anti-racism without reckoning with racism, so this course is an opportunity for folx to enhance their racial literacy by providing them with a vocabulary for identifying and speaking to each other across our differences in the service of social justice.

Some of the topics covered include:

  • Why race matters
  • What is race?
  • White matters: The social construction of whiteness
  • Racisms and their impact
  • What is racism?
  • Impacts of racism
  • Continuing your journey: Next steps

The Black Health Primer

The Black Health Primer officially launched on March 21, 2024, the International Day for the Elimination of Racial Discrimination. The Primer is an 8 module online, self-paced, and asynchronous course, comprised of quizzes, case studies, reflections, and multimedia. Designed for learners from across health disciplines, professions, organizations and communities, the Primer was created in response to gaps in education and training on Black health and anti-Black racism in medicine and public health in Canada.

The Primer describes the historical context of racial oppression, explains how anti-Black racism influences the social determinants of health, and acts as a barrier to health equity. Participants will gain knowledge about anti-Black racism and Black health and this knowledge will improve the racial literacy of health care practitioners. This will enrich the health of Black communities, as well as the health of all patients. Enhanced racial literacy is imperative, as it is integral to the delivery of anti-racist care.

Dialogues of Disruption

The third initiative is a collaborative effort by all the offices that fall under the portfolio of Dr. Marcia Anderson, Vice Dean of Indigenous Health, Social Justice and Anti-Racism. This includes the Offices of Anti-Racism, Equity, Access and Participation, and Community Engagement and Social Accountability. 

In the upcoming academic year, we will be hosting a series of events in the upcoming academic year under the title: Dialogues of disruption: An invitation to work towards more just futures.

These monthly events will address a variety of themes that correspond to our areas of work, some of which include disability justice; connections, coalitions and false equivalencies: the indivisible connections between racial, gender, and lgbtqia+ justice; and anti-racism and engagement with newcomer, refugee and immigrant communities.

We wanted to draw attention to under-served and under-represented communities, along with local organizations, exploring areas of silence, marginalization, and invisibility by providing a meeting ground to collaborate in our work towards more just futures. In this spirit we will be inviting members from some of these communities to provide their indispensable input about the needs and priorities in their communities so that we may engage with them in ways that are appropriate and meaningful. It is our hope that disrupting dialogues will offer guidance in the journey of un-learning and learning, while encouraging and inspiring change and possibility.

The first event will be an introduction to each of the Offices mentioned above and an opportunity to speak to our distinct and shared work with a Q & A at the end.

Dialogues of Disruption: Upcoming Event

This event will be held on September 24, 12 to 1:00 pm. It will be a hybrid event taking place in Basic Medical Sciences Theatre-B and online. For more information or to register, visit our event page.

We all have a role to play. We look forward to working towards more just futures with you.

Resources

Black Health Education Collaborative: bhec.ca

Knowledge One Interview Foundations of race, racism, and anti-racism: https://knowledgeone.ca/interview-foundations-of-race-racism-and-anti-racism-online-course/

January 2024: Self-care and self-preservation: Rest as radical resistance

Marcia

In 2022 it became too obvious to me that I was not going to be able to continue doing all of the work that I was doing in all the places that I was doing it. I was experiencing worsening mental health and symptoms of burnout- like over 50% of physicians who participated in the 2021 National Physician Health Survey. As noted in the Health Workforce Assessment by the Canadian Academy of Health Sciences in addition to burnout and moral distress, I was experiencing workplace violence and discrimination and that created an intention for me to partially leave the health workforce. Other research papers and reports document how often Black, Indigenous, and racially marginalized individuals experience racism in the workplace or academy, and how that increases the risk for burnout and other negative impacts to mental health. I knew that I needed to decrease the arenas in which I both experienced racial violence and was also expected to lead systemic change. I left my public health job, increased my time at the university and took July off to rest. In rest came more clarity and creativity in how I approach my work in Indigenous health, social justice, and anti-racism.

I had a head start, maybe, from having worked with a coach since 2007, being a Certified Executive Coach, and coaching others over the past year on rest and joy while doing social justice work. What has become increasingly clear to me is:

  • Black, Indigenous, and racially marginalized folks need to center rest and joy in their lives in order to be most effective at anti-racism and social justice work. This includes by honouring our own humanity, and thus creating the example and expectation for others to do the same.
  • Our burnout will not be the thing that ends or fixes racism.
  • We cannot get out of the health workforce crisis or address racism in health care without healthy, rested, well-supported Black, Indigenous, and racially marginalized folks leading the multiple forms of anti-racism work that needs to happen.
  • White people also have roles to play in anti-racism that require personal decolonization work- rest will also be a foundation for this challenging work.

Delia

“I had to examine, in my dreams as well as in my immune-function tests, the devastating effects of overextension. Overextending myself is not stretching myself. I had to accept how difficult it is to monitor the difference. Necessary for me as cutting down on sugar. Crucial. Physically. Psychically. Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”

(Audre Lorde, 1988, p. 125)

Audre Lorde wrote this essay in 1988 while she was fighting cancer. She died from the disease in November 1992. She was 58 years old.

In addition to Audre Lorde, writer/activist/scholars Barbara Christian, June Jordan, Bebe Moore Campbell, Toni Cade Bambara, Gloria Anzaldua, Claudia Tate, Beverly Robinson, Ruth Frankenberg, and Patricia Monture (to name but a few) all died from cancer. Erica Garner. bell hooks.

We persist.

Freedom struggles continue, as self-determination and emancipation remain unfinished projects.

There is no place to stand outside of racism, of white supremacy, of heteropatriarchy, of ableism.

There is a tendency to underestimate both the impact of everyday injustices and systemic discrimination and the impact of the fight against oppression.

The effects are cumulative and multidimensional. They are embodied, emotional, and psychological. They are matters of life and death.

We know racism is a public health issue and a key determinant of wellness, well-being, and health.

Fighting racism is also a public health issue and a key determinant of wellness, well-being, and health.

There is a cost for those who decide to name both the particularities of one’s oppression. There is a cost to fighting racial oppression – to fighting all manifestations of oppression.

The cost is not shared equitably.

In the university Black, Indigenous, and racialized staff and faculty have consistently had to bear the added weight of expectations, responsibilities, and burdens associated with addressing issues related to diversity and racial inequality, however, these forms of identity taxation or racialized equity labour work have become more onerous and more urgent owing to the perilous conditions borne of the pandemics of COVID 19 and racism.

We bear the brunt of racism, and we disproportionately bear the weight of addressing it.

Racism dehumanizes, rendering Black, Indigenous and racialized minority peoples as disposable.

Rest is recognition of our humanness. Rest is affirmation of our right to be…

I am mindful of Audre Lorde’s distinction between overextending versus stretching. I interpret overextending as going too far, beyond one’s capacity, to one’s detriment, while stretching involves growth and expansion, a broadening of perspectives, an unfolding of possibilities. I interpret stretching as the opposite of contracting or diminishing. Stretching is integral to the processes of learning and unlearning.

Rest, self-care, and self-preservation offer different paths forward – one that involves reflection, restoration, rejuvenation, reconnection to the many parts of ourselves that we suppress, ignore, silence.

Self-care is self-preservation.

Self-care is resistance.

            And so much more…

As Tricia Hersey explains in her book Rest is Resistance: “Rest is care. Rest is radical” (p. 12).

Here’s to a year of rest, radical care, hope, and resistance.

Resources

Canadian Academy of Health Sciences (2023). Canada’s health workforce: An overview. Available at: https://cahs-acss.ca/assessment-on-health-human-resources-hhr/.

Canadian Medical Association (2022). National Physician Health Survey. Available at: https://www.cma.ca/sites/default/files/2022-08/NPHS_final_report_EN.pdf

Fuller, Kandace. (n.d.) The heart of Erica Garner: The cost of fighting back against racial inequality. Matters of the Heart, Issue 2. Available at

https://www.womanlymag.com/matters-of-the-hearts/articles/the-heart-of-erica-garner

Hersey, Tricia. (2022). Rest is resistance. New York, NY: Little Brown Spark.

Lorde, Audre. (1988). A burst of light and other essays. Ithaca, NY: Firebrand books.

December 2023: Creating anti-racism pathways: Being the change

Delia

In August 2020, the Rady Faculty of Health Sciences Faculty Executive Council approved The Disruption of All Forms of Racism Policy (DAFR), the first anti-racism policy to be passed by any Faculty or post secondary institution in Canada. In November 2023 the Rady Faculty of Health Sciences Faculty Executive Council approved revisions to the DAFR Policy.

The DAFR Policy constitutes a formal recognition of racial harassment, racial discrimination, racial vilification, and racism. It is an affirmation of a) the histories of dispossession, enslavement, genocide, and their legacies; b) ongoing settler colonial projects; and c) the humanity, rights, dignity, and safety of Black, Indigenous, and racialized minority learners, staff, and faculty.

However, while the Policy is an important structural intervention, it represents a point of departure and not an end point.

In conversations about anti-racism, I often hear “I don’t know what to do/what should I do”?

This very question can place an added weight of expectations, responsibilities, and burdens associated with addressing issues related to racial (in)equity, racism, and racial justice on Black, Indigenous, and racialized minoritized persons. I mention this, because this question can be an expression of defensiveness/resistance, which can result in inaction.

You may be familiar with the phrase: the “only way out” is through… Some of the next steps associated with disrupting and dismantling racism(s) involve the active process of challenging one’s own biases and prejudices, as well as actively engaging in the work of disrupting systemic racism by dismantling the policies/social relations/attitudes/practices that promote and/or sustain racial inequality.

In response we have drafted a number of documents to guide and support you in your efforts to enhance your racial literacy and efforts to disrupt/challenge/eliminate the structural arrangements/policies/social relations/attitudes/practices that promote and/or sustain racial inequality and perpetuate racism.

Marcia

I spend a lot of time thinking about how anti-racist and social justice change will happen in our faculty and in the health care system. We have done a lot of work to offer educational opportunities and resources, and there are many more options to enhance your racial literacy online, at conferences and in the arts. However, as we know from every single behavioral health intervention ever, education alone is not enough. Like many aspects of organizational culture, racism is deeply embedded not just in policies, procedures and practices but also in the more invisible aspects like the stories that get told, the coded language that gets used, and the disapproval and even backlash people face when they try to speak up.

These parts of the invisible organizational culture are not things we can change from the Dean’s Office or the Office of Anti-Racism. These require us all to show commitment and leadership in meaningful action. The tools attached are meant to guide your work at the Unit, Department or College level as you seek to build your anti-racism strategies, hire more diverse candidates with anti-racism expertise, and build your own and your team’s racial literacy.

In November I launched a group coaching program to support Faculty Leaders in their anti-racism and social justice work. In 2024 the Office of Anti-Racism will be launching a council or community of practice to support you as you take action across Rady’s Units, Departments and Colleges. If we are going to have a New Year’s Resolution, let it be this: that we all develop a further understanding of our individual and collective anti-racism and social justice responsibilities, and begin (or for some continue) taking visible and meaningful action.

Resources

In November 2023, Dr. Marcia Anderson (Vice-Dean, Indigenous Health, Social Justice and Anti-Racism) launched a group coaching program to support Faculty leaders in their social justice and anti-racism work.

In 2024 the Office of Anti-Racism will launch an Anti-Racism Community of Practice- stay tuned for a formal announcement, name and dates.

This work requires all of us to understand and act on our responsibilities as members of the RFHS community.

We hope that the attached tools will help you on the next steps in your Units, Departments and Colleges. The toolkit contains the following resources:

  • Anti-Racism Strategy Template
  • Anti-Racism Resource List
  • Rady Equity, Access and Participation Strategy
  • Anti-Racism and Social Justice Terms of Reference Review
  • Anti-Racism and Social Justice Syllabus Statement
  • Guide for the Implementation of Anti-Racism and Social Justice Syllabus Statement
  • Suggested Anti-Racism Competencies for Job Descriptions
  • Rady Performance Conversation Review with Anti-Racism and Equity
  • Guideline to Anti-Racism and Equity on Performance Conversation Review

These materials can be found on the Office of anti-racism website.

March 2023: Racial matters: What is race? Who is ‘raced,’ and the role of disaggregated data in advancing health equity

“…any doctrine of racial superiority is scientifically false, morally condemnable, socially unjust and dangerous and must be rejected, together with theories that attempt to determine the existence of separate human races, …”

United Nations, 74th session, January 27, 2020.

Delia Douglas

Context – Racial Matters: What is race? Who is ‘raced’? 

As a sociologist working in the health sciences, I am continually confronted by the separation that exists between the social sciences and health sciences – a division which is not unintentional, but part of the way in which white supremacy operates through the reproduction of race-based medicine and racist assessments of patients. However, in order to disrupt and dismantle the many forms of racism that exist, we must first understand it. 

So, what is race? 

Race is a social and historical construct, not a biological difference. Despite the failure of science to demonstrate that our physical differences represent racial superiority and racial inferiority, biological racism (scientific racism) persists. There remains a profound investment in the belief that our visible physical differences signal proof of one’s ability, potential, and capacity: our humanness.

Marcia Anderson

From the time I started medical school in 1998 through the H1N1 pandemic (and beyond) with the exception of some of my Black and Indigenous colleagues, if a physician taught, talked about, or researched racial gaps in health outcomes it was framed as a question of genetic difference (e.g. the thrifty gene theory or T-cell immunity differences). Framing racial health gaps as the result of racism was unpopular, to say the least.

As an early public health doctor however, one of my role models was Dr. Camara Phyllis Jones who is an anti-racism activist and academic and former President of the American Public Health Association. She defines racism as “a system of structuring opportunity and assigning value based on the social interpretation of how one looks (which is what we call “race”), that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and saps the strength of the whole society through the waste of human resources.”

When I consider the differential impacts of COVID-19, HIV, and the new CMAJ guidance on the reporting of race and ethnicity in research articles, I see that this is where the social sciences and health sciences have to meet.

Delia and Marcia

The reason we need to talk about race is because of racism. 

Similar to race, racism is about how we make sense of difference, it is based on the false assumption that physical differences such as skin colour, bodily features, and hair texture are related to intellectual, moral, or cultural superiority. 

This enduring investment in innate difference is a matter of life and death – the belief is used to justify racial inequality, it informs policies, relationships, it influences how people are seen and treated. It denies the fact that racial meanings are dynamic and shaped by the social, historical, and political context in which they appear. The belief in race as a biological difference is an attempt to silence and suppress histories of genocide, dispossession, enslavement, heteropatriarchy, settler colonialism, and the attendant violence(s) of domination. In this context the role of science – of race as a biological difference – is employed to ensure that our differences are understood as inevitable/unchangeable/unalterable and thus don’t need further interrogation or intervention.

Who is ‘raced’?

Across North America, those typically identified as raced are those identified as Black, Indigenous, or a member of a racialized minority community. In other words, those identified as ‘non-white.’

This brings me to the matter of whiteness -whiteness is a location within the racial order and one of advantage, as highlighted by Dr. Jones. Whiteness is an element of identity and part of the system of racial categorization and while this also varies over time and place, it is shaped by the past and present of dispossession, genocide, enslavement, and settler colonialism. Usually unmarked, whiteness usually operates as the default category (e.g., the norm); whites are typically regarded and identify as ‘raceless,’ or simply human. Consider this –- to only regard Black, Indigenous, and members of racialized minority communities as racialized is an example of how a system of racial classification and hierarchy has been normalized. White people are “just human” while Black, Indigenous, and racialized minority folks are, well, regarded as something else: humans with caveats.

It is important to bring whiteness into this conversation because it is imperative that we acknowledge that we are all racialized, engendered, and sexualized (to name but a few components of our identities). Naming whiteness also signals how we are all located in relations of domination and subordination. Making whiteness visible allows space for us to understand how the marking of the so called ‘racial other’ simultaneously involves the making of the dominant…with respect to racism it means that we are able to not only recognize the harms and hardship of racism(s), but how it also benefits those who are not its targets.

Resources

Jude Mary Cenat. (2023). Who is Black? The urgency of accurately defining the Black population when conducting health research in Canada. CMAJ July 18, 2022, 194 (27) E948-E949; DOI: https://doi.org/10.1503/cmaj.220274. 

Stuart Hall (1997). Race the floating signifier. Producer: Sut Jhally. Media Education Foundation.

Camara Phyllis Jones. (2018). Towards the Science and Practice of Anti-Racism: Launching a National Campaign Against Racism. Ethnicity and Disease August 9, 2018, 28 (Suppl 1) 231-234; DOI: https://doi.org/10.18865%2Fed.28.S1.231. 

Matthew B. Stanbrook and Bukola Salami. (2023). CMAJ’s new guidance on the reporting of race and ethnicity in research articles. CMAJ February 13, 2023, 195(6) E236-238; DOI:  https://doi.org/10.1503/cmaj.230144. 

United Nations. (2020). A global call for concrete action for the elimination of racism, racial discrimination, xenophobia and related intolerance and the comprehensive implementation of and follow-up to the Durban Declaration and Programme of Action. Available at: https://documents-dds-ny.un.org/doc/UNDOC/GEN/N19/426/41/PDF/N1942641.pdf?OpenElement.

December 2022: Accountability: The relationship between data collection and disrupting systemic racism in health care

Delia Douglas

The measurement, classification, surveillance, and analysis of Black, Indigenous, and racialized minority communities in the service of white supremacy has a long history. While data collection involves achieving a balance between managing need and risk, it is clear that we are operating at a data deficit. The absence of data is a manifestation of systemic racism. In the absence of data, Black and racialized communities will be spoken for, our voices silenced, and racial inequities protected and sustained.

Marcia Anderson

My 2006-2007 masters of public health capstone project focused on developing a proposal to implement the collection of Racial/ ethnic/Indigenous identifiers in Canada because of a deeply held belief that without this we will never be able to close the gaps in health care quality and outcomes that occur by race and/ or Indigeneity. In its absence we create a health care space where we can pretend that color-blindness is good, that we serve everyone equally, and that none of us contribute to systemic racism in Canada. In reality, this further fuels racism because then we don’t examine the system design and actions that create unequal outcomes, and instead blame the people who experience them.

Marcia and Delia

Data collection provides invaluable information that can reveal patterns and guide solutions through resource allocation, quality improvement, and data-driven policy decisions, and participatory program planning. While this is not a new topic, the calls for data collection have certainly intensified over the past two years, as we witnessed the spread and disproportionate impact of COVID-19 on Black, Indigenous, and racialized minority communities in Winnipeg, across Canada, and around the world.

Building on the data collection and governance in place to monitor and provide supports for First Nations, in May Manitoba 2020 became the first province to track the racial identities of Black, and racialized minority persons who tested positive for the virus. This data revealed how COVID-19 exacerbated existing inequities and provided invaluable information about the impact of the virus on members of Black, Indigenous, and racialized minority communities, demonstrating the profound inequities in terms of the social determinants of health, highlighting their vulnerabilities, and the urgent need for a targeted response.

In 2016 the UN Working Group of Experts on People of African Descent visited Canada. Their report examined the history and legacy of systemic anti-Black racism. They identified that the lack of race-based data and research on the experiences of people of African descent, noting the need for disaggregated data to adequately address the diversity and complexity of Black identity and lived experience.

While there is no one approach that can be applied to all, creating race data collection standards and good data governance guidelines should be driven by researchers, social scientists, clinicians, and members from Black, Indigenous, and racialized minority communities and/or representative organizations. This approach will help address this systemic barrier that contributes to the economic inequality and health inequities that members of Black and racialized minority communities face across the country.

We invite readers to review the Key Considerations: Race, Ethnicity and Indigenous Identity Data Collection and Use (https://umanitoba.ca/health-sciences/sites/health-sciences/files/2022-11/Key%20considerations.pdf) as a starting point for considering your organizational/ team readiness to move forward with this work.

References

Black Health Equity Working Group. (2021). Engagement, governance, access, and protection (EGAP): A data governance framework for health data collected from Black communities. https://blackhealthequity.ca/wp-content/uploads/2021/03/Report_EGAP_framework.pdf

UN Report of the Working Group of Experts on People of African Descent on its mission to Canada. Available at: https://digitallibrary.un.org/record/1304262.

November 2022: Health and anti-Black racism the remix

“In some ways, Canada very much is a welcoming place. However, that can act as a barrier in understanding how racism manifests — it’s not just the racial slur. It’s not just the racist targeting. But it is in the very systems of continuing to practice race-based medicine. Even if we had more funding and even if we had more Black physicians and practitioners, if we do not address the very real reality of anti-Black racism — in structures and in practice — we will continue to see poor health outcomes from Black communities.”

Dr. OmiSoore Dryden, Associate Professor, Faculty of Medicine, Dalhousie University

Delia Douglas

This month’s blog continues Rady’s response to the Scarborough charter. We would first like to extend our gratitude to Dr. Onye Nnorom (University of Toronto) and Dr. Omisoore Dryden (Dalhousie University) for the October 19th workshop: #Blacklivesmatter in health care: historical roots and legacies of anti-Black racism in medicine and the October 20th grand rounds: addressing anti-Black racism in the clinical setting: a look at the social and physiological heath impacts of injustice.

Anti-Black racism – what is it and why does it matter?

Dr. Akua Benjamin, professor emeritus at Toronto Metropolitan University, conceived of the term anti-Black racism to underscore the distinct nature of systemic racism on Black people in Canada that is the result of the enduring legacies of enslavement and the colonization of people of African descent in this country. Anti-Black racism is manifest in policies and practices embedded in Canadian institutions such as, health care, education, and justice that reflect and sustain beliefs, attitudes, prejudice, stereotyping and/or discrimination towards people of African descent.

Consider that the first medical education program in Canada was established in 1824, a decade before the end of enslavement in Canada (1834), and while residential schools were operating.

In 1918 Queen’s University senate voted to ban Black students from enrolling in its medical school. At that time 15 Black men were enrolled in the university’s medical school, and while those students were not formally removed, the administration actively encouraged them to leave the program. Bolstered by the ban, white students put on a minstrel show; approximately half of the Black medical students left the program, while the other half remained. Several decades later, in 1965 Black students returned to register at Queen’s School of Medicine. The ban would not be repealed by senate until the fall of 2018 and an official apology was given in 2019.

In addition, the medical schools at McGill University, Dalhousie University, and the University of Toronto also excluded Black students, or placed restrictions on their admission, for varying periods of time.

Systemic anti-Black racism is evident in the ways people of African descent have long been used to “advance” medicine. For example, J. Marion Sims, the founder of gynecology, and the doctor credited with the creating the speculum was known for developing a surgical technique to repair vesico-vaginal fistula. His breakthroughs occurred at the expense of his subjects, namely enslaved Black women, who he operated on without use of anaesthesia. Henrietta Lacks’ cervical cancer cells were taken and used without her consent. Named after Lacks, the hela cell line represents one of the most important human cell lines in medical research; they have been instrumental in cancer studies and aids research, as well as in the creation of polio and Covid-19 vaccines.

Simply put, the past and present histories of enslavement and settler colonialism in Canada form the foundation of these institutionalized expressions of anti-Black racism in society in general, and in the field of medicine and medical education programs in particular.

Anti-Black racism(s) affect the health and well-being of Black communities in multiple ways. In addition to undermining trust in health care delivery systems and practitioners, it impacts the quality of care that Black people receive, resulting in poor physical and mental health outcomes.

It is therefore imperative that medical and health education professionals are taught about how anti-Black racism affects the social and structural determinants of health for Black people.

Marcia Anderson

In order disrupt the anti-Black racism patients experience, we have to disrupt the anti-Black racism that Black learners and health professionals’ experiences. These experiences are widespread, pervasive, and cause harm including decreased academic performance, burnout and high staff turnover. Disruption requires understanding how anti-Black racism was built into our systems.

The current special issues (volume 194, issues 41 and 42) of the Canadian Medical Association Journal (CMAJ) are an important intervention into this knowledge gap.

Resources

Visit the CMAJ website to view the two special issues on Black health and anti-Black racism in health care:

https://www.cmaj.ca/content/194/41?current-issue=y

https://www.cmaj.ca/content/194/42

Black health education collaborative: The important role of critical race theory in disrupting anti-Black racism in medical practice and education:

https://www.cmaj.ca/content/194/41/e1422

Canadian medical journal acknowledges its role in perpetuating anti-Black racism in health care

https://www.cbc.ca/news/health/cmaj-anti-racism-1.6627312

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2625534/

https://www.cmajopen.ca/content/10/4/E937

https://rnao.ca/sites/default/files/2022-02/Black_Nurses_Task_Force_report_.pdf

https://jamanetwork.com/journals/jamasurgery/fullarticle/2777800

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000324/

October 2022: Racism is a public health crisis

This first blog is an introduction and a conversation – a collaboration between our anti-racism and social justice work.

Visit the Canadian Public Health Association website for a statement on racism and public health.

Marcia Anderson

As a physician, I have seen unequal access and treatment of Indigenous, Black and racialized people in learning and work environment, and read countless journal articles documenting the same.

While we are trained as medical experts and scholars, what we know hasn’t been sufficient to disrupt or address racism in ways that have been shown to close these gaps in unequal care by race.

Delia Douglas

As a sociologist, I am attentive to the continuing significance of the legacies of enslavement, imperialism, and settler colonialism in the present.

I have examined racism’s impact in post-secondary institutions, the law and sport – and now I am working in the realm of health care.

That said, there are certainly many points of connection across different systems, organizations and institutions – the pervasiveness and persistence of racisms… I use the plural because racism is not one thing.

The events of the past two years – COVID -19 and the denial of bodily autonomy (the right to health and wellness, freedom from police violence, autonomy over gender and sexuality and the right to look after our children and families in safe and sustained communities) certainly exacerbated existing inequities and they have also produced new forms of violence.

The enduring legacies of residential schools as evidenced in the uncovering of the bodies of the 215 children who died at the Kamloops Indian Residential School (and the thousands more graves identified since), the death of Joyce Echaquan, the murder of George Floyd, and the reckoning with anti-Black racism, the rise in racism against people of East Asian descent, Islamophobia, and the death of Indigenous, Black, and racialized people in police involved shootings across the country.

These are not individual acts of racism, or the actions of a few bad apples, these are instances of systemic racism. These are acts that demonstrate how race influences who lives and who dies. Racism lowers life chances – racism kills.

I am reminded of the insights of the late Audre Lorde, a Black lesbian feminist writer poet and activist (1984). In her words, “We have the power those who came before us have given us, to move beyond the place where they were standing” (Sister outsider, p. 144).

I interpret Lorde’s remarks as both a responsibility and opportunity- our lives are shaped by all that has come before…

There is no quick fix, or toolkit, which can solve racism – if it were easy, we would be in a very different place. A new path forward towards racial justice is challenging, but possible if we commit to new learning, building relationships, cultural shifts, and structural change.

We have commitments – in our Faculty’s Disruption of all forms of racism policy, the Truth and reconciliation action plan, and Equity, diversity, and inclusion policy, and in the University’s commitment to the Scarborough Charter.

We have educational tools available (e.g., Learning module on disruption of all forms of racism policy and Manitoba Indigenous cultural safety training) and in development (e.g., Disrupting dialogues anti-racism speaker series, enhancing our racial literacy activities, and learning module on how to receive a disclosure of racism).

We all have a role to play.

What we need from our Faculty community is humility, accountability, courage, and open engagement with new learning, the application of new knowledge, and full participation in the organizational and structural changes required to create a more racially just environment.

If not now, then when?

Resources

Visit the Canadian Public Health Association website for a statement on racism and public health

Audre Lorde (1984): Sister Outsider.
Freedom, CA: The Crossing Press Feminist Series.

Disruption of all forms of racism policy