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Challenging our conceptions

Reflections on your reflection: Health care and systemic racism

Student Life

By Angela Morris

Who I am is not based on the colour of my skin, but a lot of my opportunities have been.

In matters of social justice, I have little to no standing. I was raised in a medium- to high-income home in a safe, suburban, predominately white, neighbourhood. The only way I could be more privileged is if I was born a man.

I have not experienced racism, but I have benefited from it.

Structural and systemic

Generally, racism is thought of as interpersonal or relational — the experience of personal discrimination ranging in severity from mistreatment to violence. This type of racism may be intentional or unintentional.

Systematic racism, on the other hand, is a result of the categorization of people and makes up the framework around which our society is built. A framework that works to the advantage of white people at a disadvantage to people of colour.

Memorial University held a recent screening of the film I’m Not Racist . . . Am I? to get students talking and inspire students to do something about structural systematic racism.

As a student at Memorial completing my master of public health degree, I want to discuss the issue of systemic racism in health care and the impact of racism on mental health. This is me, talking.

Systemic racism in health care

Systematic racism is based on an imbalance of power and resources maintained through unequal treatment.

Racism is socially constructed. It can involve social exclusion and can result in limitations or barriers in access to sectors of society, such as health care.

In the 2010 publication on the Social Determinants of Health – The Canadian Facts, race was listed as one of the social determinants of health. Race is an important determinant of health as it impacts the way in which one experiences and has access to many other social determinants of health.

The expectation is that professionals in the health-care system, such as physicians and other health-care providers, will be just that: professional. While it is true that most individuals will challenge overt discrimination when witnessed, many have unconscious (or conscious) biases. Canada is not immune.

In 2008, Brian Sinclair, 45, was found dead in the Health Sciences Centre’s emergency room in Winnipeg, Man., 34 hours after arriving without being treated. Mr. Sinclair was Aboriginal.

This may not seem pertinent; however, in an investigation into his death, health-care workers stated that in defence of their inaction, they assumed Mr. Sinclair was drunk and “sleeping it off.” It was September of this year that the report was released — nine years later.

What does this tragedy say about the existence of racism in the health-care system?

Racism is an issue in health care.

Impact of racism on mental health

Assumptions, bias, stereotypes, prejudice, discrimination, racism. Buzzwords.

They all mean something, but again, very few impact me directly. Ignorance is bliss until you experience a situation where everything is in reverse. But if it does not impact you, does it matter to you?

Racism exists and has long-term negative effects on individuals’ mental health. The American Psychiatric Association notes that racism impacts the mental health of people of racial minorities through stress, post-traumatic stress disorder, depression and anxiety.

As well, racism negatively impacts self-esteem and forces people into conservative and apologetic thinking. What do you think the impact on black children is when their parents feel the need to teach them to act with caution around police?

Racism is an issue for mental health.

What can you do?

There is no easy fix to racism, but it is important that we continue to talk about it so we can find a solution.

As a collective, we need to make racism an issue that deserves priority. As individuals, we must challenge our own conception of what racism is, and what racism looks like.

In health care, we need to provide culturally safe care and train professionals to recognize their own biases. We need to realize the unique socio-political context contributing to systemic racism. We need to remove barriers in access to health care. We need to recognize how racism impacts mental health. We need to speak up.

It is through difficult conversations that we elicit change.

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