Fight for Your Right: Navigating Medical Racism
by Destiny Pitters
Main photo from Mad in America
Note: Medical racism affects all racialized folks and especially those Indigenous to Turtle Island. This article specifically looks at anti-Black medical racism as that is the lens from which the author understands and can speak personally.
Although Canada is hailed on the world stage for its universal or “free” healthcare system, accessing adequate healthcare has proven challenging at times and lethal at others, especially for Black Canadians. Canada’s national history of colonialism, white supremacy and other systems of oppression not only wreaks havoc on the condition of Black minds and bodies but also on their possible health outcomes. The name for this fatal phenomenon is medical racism.
Described by the YWCA, this encompasses “the systematic and wide-spread racism against people of color within the medical system. It includes both the racism in our society that makes Black people less healthy, the disparity in health coverage by race, and the biases held by healthcare workers against people of color in their care.” Medical racism can present in many ways, from attitudinal barriers and stereotypes to underrepresentation in research to harmful malpractices. Understandably, due to all of these things, many Black children and adults are hesitant to visit a doctor when needed, which further compounds their health outcomes.
What this actually looks like in practice is nothing short of nightmarish. Take, for example, pain tolerance myths: these assert that Black people have thicker skin or duller nerve endings and are able to withstand greater amounts of pain. A 2016 US study revealed that half of white medical students believe these myths, resulting in less effective treatment, a reality that is likely extended to Black Canadians. As well, Black pain is less likely to be taken seriously by healthcare workers due to stereotypes surrounding addiction. Harm can also be done simply due to the lack of representation of darker skin in medicine, which, for example, results in the misdiagnosis of skin conditions.
Other facets of medical racism are embedded in fundamentals of contemporary health and science, like the use of the BMI scale. Created by Belgian mathematician Adolphe Quetelet in 1832, the body mass index scale was originally used to measure the height and weight of an “average” person, with a white European man being Quetlet’s ideal subject. Although he said it was a population-level tool not meant to be used on individuals, the scale was reintroduced in 1972 to measure individual health (Byrne 2022). As such, the BMI is a problematic reference point for racialized folks to measure up to a “normal” (white, male) weight standard and has been used to perpetuate medical racism, often locking Black folks out of critical treatments when their conditions are blamed on weight and overlooked. Fatphobia such as this has a very old, racist history linked to the Atlantic slave trade.
An image of UC sociology professor Sabrina Strings, Ph.D, a darkskin Black person in a yellow t-shirt, red lipstick and a necklace. In a white room, she is posed in front of her book, Fearing the Black Body: The Racial Origins of Fat Phobia. From the University of California.
In the present, and specifically for the last two years, health has been at the forefront of our conversations, worries, life choices and politics. As with many things, the COVID-19 pandemic has exposed holes in our society’s health systems and institutions, in which marginalized folks face the brunt of consequences. Black Canadians are disproportionately affected by COVID-19 due to their increased likelihood to work frontline jobs, live in poorly ventilated spaces, receive maltreatment in healthcare, and be disproportionately represented in carceral care (like prisons, shelters, group homes, etc. in which 58% of all COVID deaths in Canada have occurred).
Of course, a conversation about medicine is also a conversation about money. Medical racism is compounded by affordability, and the increased privatization of healthcare locks out lower income individuals and families. In late May, a rumour caught fire about the Ontario government covertly increasing the cost of cancer screenings via blood tests. Although disproved, it stirred an appropriate scare for Black women who are already screened at lower rates for breast and cervical cancer, and for whom a monetary barrier could prove even more challenging. An unfortunate reality here is that due to the pandemic, Canadians could face diagnostic delays as their cancer progresses, and Black Canadians already have higher mortality rates for many common cancers than the rest of the population.
There is a lot to be said about the racist pitfalls of Canada’s medical system: how it predisposes racialized folks to harm and disability, how it fails to treat them, and how scarce the solutions seem to be. But there are increasing conversations about how to do better, in and outside of the doctor’s office. When it comes to the individual, having strategies for an assertive approach to navigating healthcare is essential. Do research beforehand about symptoms you're experiencing; ask for any treatment refusals to be documented, or request access to your medical history; bring a buddy or support person to appointments if needed; and know your patient rights. Most importantly, remember that you know your body better than anyone else.
Some Ontarian/Canadian organizations combating anti-Black medical racism:
- ASE Community Foundation for Black Canadians with Disabilities
- Black Coalition for AIDS Prevention
- Black Health Alliance
- Black Gay Men’s Network of Ontario
- Black Physicians of Canada
- Canadian Race Relations Foundation
- Disability Justice Network of Ontario
- TAIBU Community Health Centre
- Women’s Health in Women’s Hands Community Health Centre
- “What is Medical Racism?” Eric Bronson, YWCA. 2020.
- “Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites.” Kelly M. Hoffman, et al. Proceedings of the National Academy of Sciences of the United States of America, vol. 113, no. 16, 2016, https://doi.org/10.1073/pnas.1516047113
- “How we fail black patients in pain.” Janice A. Sabin, AAMC. 2020.
- “The BMI Is Racist and Useless. Here’s How to Measure Health Instead.” Christine Byrne, Huffpost. 2022.
- “< Fat Phobia And Its Racist Past and Present”. Maddie Sofia, npr. 2020.
- “Where does fatphobia come from?” Heather Ashbach, University of California. 2019.
- “Time to dismantle systemic anti-Black racism in medicine in Canada.” OmiSoore Dryden and Onye Nnorom, Canadian Medical Association Journal. 2021.
- “Ford government plans unprecedented for-profit privatization of health care: Health Coalitions across the province hold summits to fight privatization and protect public health care services.” GlobeNewswire. 2022.
- “It’s Time to Abolish Long-Term Care in Canada.” Nora Loreto, Passage. 2022.
- “Support group tackles gaps in cancer care for Black Canadians”. Tom Yun, CTV News. 2022.
- “More Canadians could face late-stage cancer tied to diagnosis delays during COVID pandemic”. Lauren Pelley, CBC News. 2022.
- “What are my rights as a patient?” Settlement.org. 2016.
- “Tackling anti-Black racism in Canadian health care: Experts putting together first primer of its kind”. Alexandra Mae Jones, CTV News. 2021.