TORONTO – In Canada, many medical students are not taught specifically how to best treat black patients and how to keep anti-black racism out of health care – with patients suffering the consequences.
Now, a collaboration of leading Canadian black health researchers is coming together to change that, aiming to create a first-of-its-kind health primer to educate health care providers and ultimately improve care for Black Canadians.
“I think this is a really unique time in history, where mainstream awareness and willingness to address anti-black racism is very high,” Dr. Oni Norom told Granthshala.ca in a phone interview.
“And in my work with medical students, they are still so eager and enthusiastic to learn about anti-black racism and how they can address it and treat their own patients with respect and One can think of health care in a different light.”
Nanorom Black is one of the founders of the Health Education Collaborative (BHEC), assistant professor and associate program director of the Public Health and Preventive Medicine Residency Program at the Dalla Lana School of Public Health at the University of Toronto.
The Black Health Education Collaborative (BHEC) has been in the works for some time, but the collaborator is officially shutting down after the pandemic, with an executive director’s announcement this August that both halted and exposed its progress. Why is this work necessary?
“The three areas we want to talk about [are]Anti-Black racism and how it affects health; how this affects the quality of care that black people receive when they are in health care; And then third, to really increase the community voice, solutions and perspectives to improve the quality of health care that black people and many different members of our society receive,” Norom said.
Primer itself, as well as modules for educating medical students Hoping to come next year.
How did the collaborative start?
The need for greater attention to black health existed long before the pandemic appeared in our health care system.
Nanorom took on the role of Black Health Team Lead for the Faculty of Medicine at the University of Toronto in 2016, a role where she was tasked with providing educational material about black racism and its impact on patients.
She said it has become clear that in Canada, when it comes to health curricula for care providers such as nurses and medical students, either data from the black population was not included in the lessons, or US data in the curriculum. was used.
“So even though we are the third largest, quotable, visible minority group in Canada, either the content didn’t contain anything about us or it was often misinformation,” she said.
Although the problem was obvious, it was not that easy to reach a solution.
“There is no textbook or online resource that really talks about black population health in a Canadian context and the social factors affecting the health of the black community and all the other conflicting factors like culture, and the lack of race-based data . ,” He said.
Norom studied at the James R. in Black Canadian Studies at Dalhousie University. Johnson Chair Dr. Omisur spoke with Dryden about the issue, and the two decided to bring together a group of black scholars, health experts, and researchers to address the issue by producing. education material.
In 2019, they began shaping modules and raising awareness, doing projects such as providing webinars for leaders in health care. And then the pandemic struck.
COVID-19 not only stopped his work. It shifted the focus.
During 2020, the way COVID-19 was disproportionately affecting black and racial Canadians came to the fore. And that summer, the racial count soared across North America after a white police officer killed George Floyd, a black man in the US.
Nanrom said the issue of anti-black racism in Canada has been clear for a long time – the United Nations even submitted a report in 2017 calling on Canada to address the anti-black racism stemming from the country’s history of slavery Was – 2020 Those who were not paying attention before finally opened their eyes.
“I think Toronto Public Health and other public health organizations, when they declared black racism a public health crisis last summer, also helped to create awareness in health care,” she said.
“So now we were facing a situation where we no longer had to explain what anti-black racism was to our colleagues in health care, [and] There was more awareness that this was a problem.”
So BHEC decided to think big.
“We really expanded our vision to provide modules and online resources not only for medical students and other health professional students, but also to the faculties, so the people who are the teachers who will be teaching that material, and really the field. people working in it now,” Norom said.
The pandemic also showed the benefit of collecting race-based data, something Nanorom said Canada does not do enough when it comes to health care.
“With the COVID-19 pandemic, what had been advocated for collecting race-based data, when it came to COVID-19 infections, got us by August of 2020, we realized in Toronto that 89 percent of COVID – The 19 cases were black and racist people in Toronto,” Norom reported.
“And so that allowed to identify the many social factors and vulnerabilities that black and racial people were facing and it became possible to advocate for resources and change because realizing these were issues of the system.”
If we don’t collect this type of data in other areas of health care, it becomes harder to spot inequalities and advocate for greater support.
How a lack of education on black racism affects health care
Nanrom explained that when health care providers are not properly educated about black racism and black health there are many consequences for patients.
Care providers can have implicit bias, which occurs when they apply stereotypes to their work without even knowingly applying it.
“Many of the stereotypes about us stem from the legacy of slavery here in Canada and throughout North America. So these myths about our pain threshold, for example, like we have a different pain threshold or thicker skin, mean you see a lot of black patients getting treated for pain,” Norom said. said.
Other negative stereotypes she has observed are that black patients are “not to be trusted” or less intelligent, which can lead not all health care providers to trust patients who are describing their lived experiences. Huh.
“All of these can affect the care someone receives,” she said. “The other way this may also be at play is that health care providers may not realize all the different ways in which racism affects the life experience of black people.”
This may mean that health care providers do not understand the daily stress of racism, or downplay the mental-health conflicts that arise from it, leaving them unable to fully relate to the patient and understand that How these factors affect physical and mental health.
The third way that anti-Black racism pervades the health care system is through explicit bias, Norom explained.
“Sometimes people make outright assumptions about where a patient might come from or assumptions about their beliefs based on their culture, or the color of their skin. And those kinds of obvious bias the therapeutic relationship. Because it affects trust, right?”
She cited the example of a young black man going to a doctor’s appointment in a hoodie and telling the doctor he was a law student, only for the doctor to react with visible surprise.
“For that young black guy who constantly feels or doesn’t believe in having cards and has put all this hard work to get into law school, now it has broken the trust between that patient and that provider,” she said. said.
She hopes that by providing more education to health care providers and physicians, they will be more aware of their biases and more aware of the life experiences of various patients they may face.
Another goal is to motivate institutions to implement policies and regulations about anti-black racism in their workplaces to keep track of and stamp it, such as monitoring whether black patients are treated by other people. Patients are left waiting longer in the waiting room than they are, and this has consequences for care providers who use anti-black rhetoric.
This project is not just about teaching about the damage caused by black racism, and where improvements can be made.
A big part of the wider project, Norom said, is also scaling up the solutions the community has put forward.
“There are many people who have experienced who can talk about alternative approaches to be able to really treat all patients with respect,” she said.
“Members of the black community who have been advocating for so long but haven’t been heard regarding abuse in health care.”
As an example, she explained that at the community health center she worked at, she learned of a South African philosophy called ubuntu, which means recognizing the humanity in all.
“It was suggested by the community and became a way we approached how we provided health care,” she said.
It is a philosophy that has been instrumental in his work trying to do community outreach about COVID-19 vaccines. She explained that there is a greater distrust of vaccines in black communities, which stems from how the community has historically been abused in the health care system.
“We apply that philosophy to Ubuntu, of really watching people…