Insights March 2024

From Conversation to Action: Collaboratively Addressing Anti-Black Racism

Jenell Austin, Dipti Purbhoo, Keddone Dias, Shereen Rampersad, Sahilaa Thevarajah and Judith Versloot


Anti-Black Racism: Context

Anti-Black racism (ABR) was named a public health crisis in Toronto on June 8, 2020, and in the Region of Peel on June 11, 2020. Black communities in these regions were facing (and continue to face) inequitable access to vital resources including healthcare in the midst of a global pandemic.

The social determinants of health (SDoH) framework positions health beyond medical factors. It demonstrates how social factors such as education, employment and food security have a significant impact on the health outcomes of marginalized communities. By embracing the SDoH perspective, we come to recognize that achieving health equity is not merely about having access to healthcare; it entails addressing the holistic needs of individuals through the provision of appropriate health and social services. Moreover, through this lens, we gain an understanding as to why Black neighbourhoods were hit the hardest by the COVID-19 pandemic: their inequitable access to social resources resulted in poorer health outcomes in comparison to the general population.

The healthcare system is not exempt from ABR. Research indicates that racial biases held among healthcare professionals can create unsafe environments for clients and colleagues alike. A 2022 study on racism in Canadian nursing education highlighted the prevalence of a bias toward whiteness in nursing courses, and the resulting dismissal and ignorance of the experiences of Black colleagues. When left unchallenged, this bias manifests in micro and macro aggressions that uphold barriers to recruitment and retention of qualified Black professionals, and fosters an unhealthy work environment with damaging effects on the health of Black workers.

Collaborative Action: How Two Ontario Health Teams Responded

By the time ABR was named a public health crisis in Mississauga and West Toronto, the Mississauga and West Toronto Ontario Health Teams (MOHT and WTOHT, respectively) had proactively initiated efforts to address ABR for healthcare organizations. The SDoH framework forms the foundation for the wraparound, holistic health programs and services OHT member organizations offer. By December 2020, MOHT and WTOHT members formed a collaborative ABR Working Group to seek federal funding to support their work. Additionally, the group found it necessary to seek insights into the experiences of staff in MOHT and WTOHT member organizations regarding ABR.

To gain this insight, an Anti-Black Racism Organizational Self-Assessment Survey (which had been used by member organizations in other contexts twice before) was distributed among 20 member organizations. Before distribution, the Institute for Better Health (IBH) was engaged in the project to support further validation of the survey, the distribution and analysis of the data.

A total of 617 people filled out the survey, with 22% of respondents identifying as Black. The results provided substantial feedback: Black staff indicated that they were likely to have experienced or witnessed racism and/or discrimination with their organizations, but also felt more confident in tackling ABR in comparison to non-Black counterparts. Staff also raised concerns about processes that were or were not in place to recognize and address ABR within their organizations. Respondents identified that their organizations needed:

  • “safer” environments for open communication about ABR;
  • opportunities for staff to learn more about ABR, and strategize solutions;
  • policies that identified the existence of ABR, and offered clear avenues for staff to address concerns, make complaints and receive support; and
  • representation of Black staff across all positions, especially positions of leadership.


From Conversation to Action

After sharing the survey results and gathering feedback on the findings, MOHT and WTOHT member organizations committed to the following:

  1. hiring a project lead who would coordinate various initiatives by the OHT ABR Working Group;
  2. providing training and educational opportunities (which to date have been accessed by over 200 individuals); and
  3. forming a community of practice - the ABR OHT Learning Network - that provides information and tools to address ABR directly to staff in health and social service organizations.

 One year later, through the power of collaborative action the following have been achieved:

At the organizational level, OHT member organizations have and still are actively unpacking their individual survey results. One example is the work of Services and Housing In the Province (SHIP) in the Region of Peel, whose BIPOC [Black, Indigenous and Other People of Color] Caucus took an intentional look at the results of the survey, and at their organization’s current state. The results informed the development of a collaborative ABR strategy with 33 different action items, including policy, recruitment and retention and representation among leadership and staff. Some of the tangible action items that they have implemented over the past year include the creation of safe spaces for and by Black staff, which will then lead to further initiatives to address ABR and offer greater support to Black staff. 


Fear and hesitation are natural parts of any health equity journey. Despite the validity of these feelings, systems of oppression depend on our hesitation to maintain the status quo. Engaging in anti-Black racism work does not necessarily require experts or even professionals. If there is anything that we hope you take away from our story, it is this: Just start and, when you can, do the work together.

For more information on resources mentioned in this essay, please visit the West Toronto OHT website.

About the Author(s)

Jenell Austin, Project Manager – Combatting Anti-Black Racism Initiatives, LAMP Community Health Centre. Jenell is a social worker who currently works with Mississauga and West Toronto Ontario Health Team member organizations, to support initiatives to address Anti-Black Racism. Author can be reached at

Dipti Purbhoo, Executive Director, The Dorothy Ley Hospice. Dipti is a registered nurse with over 20 years of experience in home and community healthcare, and currently co-leads the Integrated Palliative Care Strategy with the Mississauga Ontario Health Team (OHT), a group working to implement a new integrated palliative care model for Mississauga.

Keddone Dias, Executive Director, LAMP Community Health Centre. Keddone has over 20 years of experience in the not-for-profit sector, and currently co-leads various health equity initiatives as part of the Mississauga and West Toronto Ontario Health Teams to improve health outcomes for equity deserving communities

Shereen Rampersad, Equity, Diversity and Inclusion Manager, Services and Housing In the Province. Shereen has been in the social and health service sectors for the past 23 years, focusing her practice in the last 2 years on the development and commitment to Equity, Diversity and Inclusion for clients, staff and community.

Sahilaa Thevarajah, Project Manager, Mississauga Ontario Health Team. Sahilaa currently works on supporting strategies around health equity, mental health and addictions and patient and community engagement and Mississauga Ontario Health Team.

Judith Versloot, Scientist, Institute for Better Health, Trillium Health Partners. Assistant Professor (Status-Only), Institute for Health Policy, Management, & Evaluation, University of Toronto. Judith is a health service researcher who studies integrated care within a learning health system with a focus on vulnerable populations.


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