Reflection on Anti-Black Racism

The w

orld is a different place. The challenges we are all facing with the global pandemic that is COVID 19; how it affects our health, our connectedness and uncertainty about the future is at the forefront of our collective human existence. It is poignant, that within this context, the longstanding crisis of racism has also emerged as a global conversation. This pandemic has disproportionately affected racialized peoples, more specifically Black and Hispanic people, in the United States. This also seems to be the case in Canada, but data is lacking. This has been a longstanding issue in Canada, with the lack of data specifically looking at health care outcomes in racialized groups. This must change.

The egregious treatment of racialized groups in the United States, famously highlighted by the murder of George Floyd by police, has many Canadians feeling as though this is an American problem. Anti-black and anti-indigenous racism has been deemed a Toronto public health crisis. In all facets, be it healthcare, education, policing, employment, or housing, there is a disparity in the experiences of racialized groups. In a community as diverse as Toronto we have a responsibility to recognize the issues and to address the systemic framework that allows these inequities to continue.

Our health care system is complicit in anti-black racism. Racial disparities are widespread in healthcare. Largely American data reveals alarming differences in outcomes with diabetic patients, maternal mortality during childbirth, melanoma, and SARS-CoV-2 infection as examples.

Black physician experiences also provide another powerful example of racism in healthcare. In 2016, at Grand Prairie Hospital, a white surgeon tied a noose to the operating room door directed at a black physician. This violent and racist act was reported to the hospital, and governing physician body but no action was taken. Recently the Minister of Health has called into question the handling of the incident. In a recent CBC article, physicians of color described incidences of racism they encountered during their training. I recall being a medical student standing with a resident on the first day of a surgical rotation and being assumed to be custodial staff and ordered to clean a spill despite wearing the same scrubs the resident was wearing (there is nothing wrong with being custodial staff, it’s the assumption that’s the issue here). I recall on another “first day” a staff physician barking at the fellow without addressing me “does this one at least speak English?”. These are termed micro-aggressions, but there is nothing micro about them. They can be subtle, insidious, but nonetheless powerful at making one feel unsafe and marginalized. Implicit bias refers to the unconscious attribution of qualities by an individual to a member of a social group. It has significant implications for education, evaluation and the student experience.

Two years ago, myself and a colleague encountered a patient who demanded to see a “white doctor”. The patient had made the request when addressing the front desk, and then ultimately when in a patient room. This prompted an institutional response, with our input, that gave clarity to staff and patients about what was considered inappropriate. It was a step in the right direction. It is not enough. The current climate underscores there is much to be done.

What can we do?

We can validate experiences, both of our patients and our colleagues. We can acknowledge our privilege. We can speak up. We can report. We can define systemic barriers. We can collect data for healthcare outcomes. We can be intentional and proactive in our decision making. We can be committed to change.