Racism in healthcare

Mar 2, 2021 | In Writing

Guest blog by Katya Korol 

Katya Korol is an Interdisciplinary Studies Master’s student at the University of Northern British Columbia. She has settler ancestry and writes this blog as a humble learner and from an empathetic perspective—not from a place of lived experience. 

The Black Lives Matter movement brought concerns about racial injustice to the forefront of public attention and sparked conversations that were long overdue. The Obama presidency in the US and the ‘Trudeau era of reconciliation’ in Canada seemed to mark the beginning of ‘post-racial’ or ‘post-colonial’ worlds for many non-racialized folk. However, scholars and activists note the fallacy in using this ‘post’ language to characterize ongoing systems designed to uphold racial and colonial injustice. They testify that racism is alive and well in this alleged ‘post-racist’ society, and the Canadian health care system is no exception.

Systemic racism is when political, economic, and social institutions are informed by, and uphold, racial discrimmination. The vastly different police response to the Trump/MAGA riots compared to the BLM protests is a recent example of systemic racism (and a manifestation of white supremacy). Indigenous people being the most disproportionately overrepresented group in Canada’s criminal justice system and being more likely to be sentenced to imprisonment for crimes is another example. 

But we know that racism is not a problem exclusive to policing. Systemic racism is widespread in our health care systems. This is manifested in racialized people receiving fewer referrals, longer wait times, and disrespectful treatment in health care facilities. When Joyce Echaquan’s facebook live video exposed the horrific and racist treatment she received in a Quebec hospital before her death, this came as no surprise to Indigenous scholars, activists and health care users. 

A 2020 report reaffirmed what so many before have attested to—anti-Indigenous racism being rampant in the Canadian health care system. In July of 2020, British Columbia’s Minister of Health, Adrian Dix, appointed Mary Ellen Turpel-Lafond the lead of an independent review on anti-Indigenous racism in the health care system called The Addressing Racism Review. The review was conducted by the independent reviewer and a small number of team members. The team gathered data through various methods including surveys, interviews, health sector data analysis, allegations examination, a literature review and key document analysis. 

In addition to finding widespread Indigenous-specific racism in the B.C. health care system, the review found that Indigenous women and girls are disproportionately affected by this racism which ultimately serves as a barrier to accessing medical care. Not only did patients experience anti-Indigenous racism, but so did Indigenous health care professionals. This is especially noteworthy because experts suggest that having more Indigenous representation in the health care system would help to foster more culturally safe health care environments.

The review further notes that Indigenous-specific racism is particularly detrimental in the context of public health emergencies, such as the COVID-19 pandemic and the opioid crisis. With Indigenous people disproportionately affected by these public health crises, their access to respectful and diligent care is critical. Unfortunately, the COVID-19 pandemic has only exacerbated the difficulty that Indigenous people face in accessing the health care system.

In addition to overt discrimmination, researchers and the general public are increasingly recognizing the more subtle, but nonetheless detrimental, ways in which systemic racism negatively impacts health outcomes. For instance, research on African American and Hispanic peoples’ experiences living with HIV in the US found systemic racism resulted in patients’ perceiving health care settings as dehumanizing and health care providers as untrustworthy.

This distrust in medical institutions and health care providers is not a random nor unwarranted sentiment held among some racialized folk. Rather, it is directly connected with historical memory. For the US and Canada, this history includes scientific racism and eugenics. Discriminatory narratives describing race as having a biological basis perpetuated (and continue to perpetuate) racial hierarchies leveraged to justify modern eugenics. For instance, in 2000, Alabama became the last state to lift its law banning interracial marriage. Further, Indigenous women in Canada were subject to forced sterilization for decades and as recently as 2018. 

It is clear that we desperately need to do more to address health inequities which persist in so-called Canada today. An article by the NEJM suggests four key areas where health care professionals can focus their attention to help dismantle systemic racism. These include documenting the impact that racism has on health (something that is only now gaining attention in major medical journals), making data which critically includes race and ethnicity more available, reflecting on how the health care systems we are part of continue to perpetuate and uphold racist policies and practices (this includes the “uncritical use of racial categories, which reinforces implicit assumptions that racial differences are genetic in origin”), and lastly, supporting social movements which challenge racist structures. 

Western medicine—a system that many privileged people benefit from— has a long colonial and racist history (and present). Let’s recognize these ongoing injustices and all take responsibility for dismantling these structures which do not serve us all equally. 

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