Where Do We Go from Here? Confronting Racism in Healthcare
Where do we go from here? I have been debating this question internally for the last several months as I feel conflicted, confused and deeply guilty for not having acted sooner. The Black Lives Matters (BLM) protests in response to the police killings of George Floyd and Breonna Taylor (McGreal et al. 2020) – and generations of systemic violence against the Black people before them – brought to the forefront how desperate the situation is if you have to remind society that your life has value. It also showed how backwards we have been in supporting Black communities if the response to those protests is more unrestrained violence.
As Canadians we are not special or much different from our neighbours. Racism, both individual and systemic, is rampant throughout our country. And no, the health system is not the altruistic, infallible institution we believe it to be. As COVID-19 spread through Toronto and other urban centres in Ontario, it was shown to impact Black, Indigenous and racialized communities at disproportionately higher rates than other mostly white neighbourhoods (Amin and Bond 2020). While the pandemic raged on, we also witnessed Ejaz Choudry (Mississauga, ON), Chantel Moore (Edmunston, NB), D’Andre Campbell (Brampton, ON) and Regis Korchinski-Paquet (Toronto, ON), all die after the police responded to their call for help during mental health crises (Gamrot 2020). These are failures of our health system to protect, care for and support the health and wellbeing of our communities.
We have been here many times before. This may be a flashpoint, perhaps, but for Black and Indigenous people, dealing with racism is a 24-7-365 job and that includes interactions with the healthcare system. Race is at the intersection of many social determinants of health, and racialized people experiencing poverty, food insecurity or disability face significant challenges while accessing healthcare. In June, 2020, the Toronto Board of Health voted to declare anti-Black racism a public health crisis (Kopun 2020) that provided some acknowledgement of the problem, albeit with no clear funding allocation.
In response to the BLM movement, organizations around the world – including hospitals, health centres and private industries – released statements to affirm their stances against racism and commitment to diversity (Hsu 2020). Some even added new equity, diversity and inclusion (EDI) roles to activate these strategies. Few committed to any real systemic change.
Systemic racism is complex and integrated into almost every part of the health system (a misnomer because healthcare, as we know it, comprises many countless systems). At one point in time, discrimination and segregation in health (the delivery and the professions) were very much a deliberate design. We are now dealing with the remnants of those very policies and practices still having an impact on racialized communities. Racism is something white healthcare leaders have never and will never experience in their lives. Leaders who truly want to change their organizations into safe spaces for the communities they care for, and for their own staff and professionals, need to acknowledge that this problem is not going to be addressed with a few seminars and diversity postings. Real change is going to be hard. Real change is going to take time. Real change is going to cost money. Real change will make many people in power very uncomfortable.
All of us working in the health system have a duty of care to disrupt our very Canadian inertia on the issue and move from not being racist to actively being anti-racist. This means starting a more meaningful journey to tear down the structures that are keeping our communities at constant risk, even if those structures are hidden to us. We all have a part to play — it begins with a long hard reflection on what we are doing and whether it is having an impact or filling a requirement. The latter can no longer be an option.
Protests on the streets continue, and the courage of those standing up for positive change is inspiring. I am withholding my usual cynicism. I believe this is a special time, truly. The momentum is strong and we are ready for change.
About the Author(s)
Adnaan Bhyat BSc, MBA, is a hospital and healthcare consultant and project manager.
Connect with Adnaan on LinkedIn: https://www.linkedin.com/in/adnaanbhyat/.
Follow him on Twitter: @adnaaninTO.
Amin, F. and M. Bond. 2020, July 9. COVID-19 Disproportionally Impacting Black Communities, People of Colour in Toronto. City News. Retrieved August 6, 2020. <https://toronto.citynews.ca/2020/07/09/race-data-covid-toronto/>.
Gamrot, S. 2020, July 14. How the Death of Mississauga Man Ejaz Choudry Helped Spark a Provincewide Conversation about Police Reform. The Star. Retrieved August 6, 2020. <https://www.thestar.com/news/gta/2020/07/14/how-the-death-of-mississauga-man-ejaz-choudry-helped-spark-a-provincewide-conversation-about-police-reform.html>.
Hsu, T. 2020, May 31. Corporate Voices Get Behind ‘Black Lives Matter’ Cause. The New York Times. Retrieved August 6, 2020. <https://www.nytimes.com/2020/05/31/business/media/companies-marketing-black-lives-matter-george-floyd.html>.
Kopun, F. 2020, June 8. Anti-Black Racism a Public Health Crisis, Says Toronto’s Board of Health. The Star. Retrieved August 6, 2020. <https://www.thestar.com/news/city_hall/2020/06/08/anti-black-racism-a-public-health-crisis-says-torontos-board-of-health.html>.
McGreal, C., M. Koran, A. Rao, A and M. Singh. 2020, May 30. Protests Rock Cities Across US as Anger Over George Floyd's Killing Spreads. The Guardian. Retrieved August 6, 2020. <https://www.theguardian.com/us-news/2020/may/29/george-floyd-killing-protests-us-police>.
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