Black Canadians’ Exposure to Everyday Racism: Implications for Health System Access and Health Promotion among Urban Black Communities

Abstract

This study explores the social determinants of Black Canadians’ exposure to everyday racism, its relationship to health system access, and implications for health promotion. We used data from the A/C Study survey on HIV transmission and prevention among Black Canadians. We implemented the survey ( N = 1360) in 2018–2019 in Toronto and Ottawa—two large cities that together account for 42% of Canada’s Black population—among self-identified Black residents aged 15–64 years, who were born in sub-Sahara Africa or the Caribbean or had a parent who was born in those regions. Participants reported racist encounters in the preceding 12 months using the Everyday Discrimination Scale. We assessed the socio-demographic correlates of racist experiences and the impact of racism on health system access using multivariable generalised linear models. Sixty percent of participants reported experiencing racism in the preceding 12 months. Based on the adjusted odds ratios, participants were more likely to experience racism if they were older, employed, Canadian-born, had higher levels of education, self-identified as LGBTQ + and reported generally moderate access to basic needs and adequate housing; and less likely to experience racism if they lived in Ottawa, self-identified as female or reported higher levels of social capital. Visiting a healthcare provider or facility, and difficulty accessing healthcare were associated with racist experiences. Racist experiences diminished the likelihood of being tested for HIV. Racist experiences were widespread, especially among those with higher levels of social wellbeing or greater exposure to Canadian institutions. Study participants also associated racist experiences with the healthcare system.

Impact of the COVID-19 Pandemic on Black Communities in Canada

“…In Canada, the focus on mistrust and vaccine hesitancy has centered on a lack of cultural competence and representation among healthcare providers [ 35 ]. Research shows that systemic anti-Black racism is prevalent in the Canadian healthcare system, impacting Black patients [ 36 ] and health professionals [ 37 ]. Our findings suggest not only a need for greater cultural training among providers and an increase in the number of Black healthcare professionals but also increased connections between communities and healthcare leaders.…”

Vaccine mistrust among Black individuals in Canada: The major role of health literacy, conspiracy theories, and racial discrimination in the healthcare system

“…While a color-blind approach to race issues plagues Canada, it is essential to increase efforts to create a healthcare system free of racism, a system of training for healthcare professionals that addresses racism at the interpersonal, institutional, and systemic levels, and that takes into account its impact on the lives of Black individuals and racialized people. [43][44][45][46] Trainings have been developed in Canada and are just waiting to be implemented. 47,48 The findings on health literacy provide an opportunity to develop strategies and programs to strengthen the knowledge of Black individuals.…”

“…Furthermore, there is an urgent need to implement existing tools to reduce and eliminate racial discrimination in the healthcare system. A recent study showed that 53.1% of Black individuals between the ages of 15 and 40 reported experiencing major racial discrimination in healthcare services 43 . This is a major issue that needs to be addressed not only for Black communities but also for Indigenous and racialized communities in general.…”

“…This is a major issue that needs to be addressed not only for Black communities but also for Indigenous and racialized communities in general. While a color‐blind approach to race issues plagues Canada, it is essential to increase efforts to create a healthcare system free of racism, a system of training for healthcare professionals that addresses racism at the interpersonal, institutional, and systemic levels, and that takes into account its impact on the lives of Black individuals and racialized people 43–46 . Trainings have been developed in Canada and are just waiting to be implemented 47,48 .…”

“…A recent study showed that 53.1% of Black individuals between the ages of 15 and 40 reported experiencing major racial discrimination in healthcare services. 43 This is a major issue that needs to be addressed not only for Black communities but also for Indigenous and racialized communities in general. While a color-blind approach to race issues plagues Canada, it is essential to increase efforts to create a healthcare system free of racism, a system of training for healthcare professionals that addresses racism at the interpersonal, institutional, and systemic levels, and that takes into account its impact on the lives of Black individuals and racialized people.…”