Today (March 21) is the International Day for the Elimination of Racial Discrimination and we’d like to speak to you about racism and health. Recognized annually around the globe, March 21 is an opportunity to reflect on progress towards diversity, equity, and inclusion. It’s also a time to re-commit to ending racism, discrimination, and hate individually and as a society every day.
Re-committing first requires acknowledging that racism exists in our community and in our country. In health, stories of racism against Indigenous patients are the tip of the iceberg of racist experiences. Recall the 2008 death of 45-year-old Brian Sinclair, who was ignored for 35 hours while awaiting care in the Winnipeg Health Sciences Centre Emergency Room. More recently, 37-year-old Joyce Echaquan was subjected to racist abuse by health care providers in her dying moments.
We have also heard local experiences of racism in health care that equally break our hearts.
Everyone deserves dignity, safety, and access to the conditions that will allow them to live healthy and fulfilling lives. Racism, discrimination, and hate stand in the way of these goals, and the evidence shows this has a really bad impact on health.
Racism is a big driver of unfairness, or inequity, in health. This can be reduced by addressing racial discrimination in our health and social systems. In Canada, these systems have been and are deeply influenced by white supremacy and by colonialism. White people contribute to and benefit from systemic racism — sometimes intentionally but often unknowingly. For Indigenous peoples, racialized communities, and religious minorities, experiences of racial discrimination within our systems and institutions are a harsh and daily reality.
The COVID-19 pandemic provides many examples of how racial discrimination prevents health equity. For example, data from cities such as Toronto and Ottawa show that COVID-19 infection is 1.5 to 5 times higher among racialized populations than non-racialized groups. Why is this? How can we explain the difference?
Answers can be found in understanding how social factors such as our living and working conditions influence health and wellness, and how racism impacts these outcomes. Sometimes health is impacted by things we control, decisions we make day to day, but often it’s shaped by things outside of our control. Not having enough money, precarious employment, or living in overcrowded or unsafe conditions can increase the chance of illness and chronic disease. These non-medical factors are called the social determinants of health (SDoH), and they are more important to health than access to health care and our genes combined.
Due to systemic racism, racialized communities are more likely to be working in conditions that are unfair and unjust, such as working in front-line or essential occupations, where contact with other people is frequent and opportunities to work from home are limited. This was especially critical during peak COVID-19, before vaccines were available and lockdowns were ongoing. When we acknowledge the impact of racial discrimination, we have a better understanding of why COVID-19 wasn’t experienced evenly across our population.
Peterborough Public Health is committed to addressing racism. We know that racism is a public health issue, and that discrimination, prejudice, and hate have no place in our programs and services, or the broader health care system. Full stop.
We can all work towards ending racial discrimination and contribute to building health equity in our communities. As individuals, we can recognize our own social positions and educate ourselves on how racism affects health. We can also monitor and challenge biases that lead to unfair differences in health, beginning with our own. Consider taking an implicit bias test to better understand how we can participate in racism, often without knowing it.
For organizations, eliminating racism in our workplaces and institutions is urgent and critical work. To move forward, we need to build our understanding of how unfair differences show up in our services and settings. Collecting and interpreting race-based data can help us expose and understand whether racial and ethnic disparities exist, and whether these are decreasing or getting worse. We also need to continuously work towards allyship and solidarity with racialized communities and organizations.
Today and every day, the work to achieve health equity cannot wait. Together we can create communities that are safe, inclusive, and healthy for all.
Kathryn Wilson is chair of the board of health for Peterborough Public Health and is an elected councillor of Hiawatha First Nation.
Dr. Thomas Piggott, MD PhD CCFP FRCPC, is medical officer of health and chief executive officer of Peterborough Public Health. You can follow Dr. Piggott on Twitter @twpiggott.
Joy Lachica is a local leader and politician living in Nogojiwanong/Peterborough, Ontario. Her career has been rooted in education, as a classroom teacher, as an elected member of the Elementary Teachers Federation of Ontario and as president of the Elementary Teachers of Toronto. Joy is Town Ward councillor for the City of Peterborough, where she resides.