Equity, Diversity & Inclusion: Race, Ethnicity & Culture

A comment on 'Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites' By Hoffman, et al.

Despite race being a socio-political system of categorization without a biologic basis, race has historically and continues to play a role in medical teaching and clinical decision making within health care. Race permeates clinical decision making and treatment in multiple ways, including: (1) through providers’ attitudes and implicit biases, (2) disease stereotyping and clinical nomenclature, and (3) clinical algorithms, tools, and treatment guidelines.

Why are black people sicker, and why do they die earlier, than other racial groups? Many factors likely contribute to the increased morbidity and mortality among black people. It is undeniable, though, that one of those factors is the care that they receive from their providers. Black people simply are not receiving the same quality of health care that their white counterparts receive, and this second-rate health care is shortening their lives.

What does it mean to be an ally?

A statement on the Social Determinants of Health from The First Nations Assembly.

This report presents a national description of the social determinants of health among First Nations adults living in First Nations communities in Canada, including community wellness, education, labour force characteristics, personal health practices, health services, culture, and the physical environment.

Canada’s Truth and Reconciliation Commission was established in 2008 to interview Indigenous peoples who had been in Residential Schools and publicize their stories. At its conclusion in 2015, the commission identified 11 areas in which healthcare disparities remain greatest between Indigenous and non-Indigenous Canadians, including a life expectancy of 14 years less for Indigenous peoples.

Reports issued or created by the Truth and Reconciliation Commission of Canada (TRC).

For award-winning Anishinaabe artist and activist Waawaate Fobister (they/them), accessing care in health systems that weren’t designed for or by Indigenous people can require an “exhausting” performance to be taken seriously. “I hate that I have to turn it on in every single institution,” Fobister says.

Five years after Canada’s Truth and Reconciliation Commission issued calls to action, and 12 years after health care workers ignored Brian Sinclair as he died in a Winnipeg emergency department, the death of Joyce Echaquan last fall underscored how unsafe hospitals remain for many Indigenous people.

Dr. Alika Lafontaine, U of A associate clinical professor and president-elect of the Canadian Medical Association, reflects on the current state of health care for Indigenous peoples and the shift it will take to overcome health inequities on the journey toward reconciliation.

Best practices for improving the clinical are of Indigenous Peoples.

Three traditional knowledge keepers share their Indigenous perspectives on Cultural Safety. Explore the Mohawk, Cree and Inuit world view on how to create a safe environment for Indigenous people.

Fixing the way in which healthcare is delivered to Indigenous people is a massive, complex undertaking on the national scale. However, on the smaller scale, simple things can be done at the first point of contact, and throughout the care organization that will make a world of difference to not only the Indigenous patient but also to the health care practitioners.

Explore the significance of the four sacred medicines.

Links to health issues that affect American Indians and Alaska Natives.

This paper provides a targeted review of literature on various models of Indigenous health governance implemented across Canada and globally that have led to improved access to primary health services, greater ownership, control and management by Indigenous Nations, and improved health outcomes. Its purpose is to inform the creation of new health governance structures and funding models in Canada that support the devolution of health services and self-determination.

Links to health issues that affect Asian Americans.

Dr. Kwon employs a social determinants of health framework to implement and evaluate evidence-based strategies in community
settings, focusing on cultural relevance and impact and finding more effective channels through which to
translate research into practice.

Yale community members spoke on the importance of cultural competency in treatment and how Asian American communities may experience and view health care differently.

Three approaches to addressing factors associated with immigration were applied in a cross-sectional investigation of Asian-White health inequalities in Canada.

Canadian South Asians are being economically, socially, politically, and culturally impacted by the COVID-19 pandemic. There is currently a gap in the literature on the unique challenges faced by this specific group of individuals. People of color and ethnic minorities are being homogenized in the media and throughout the literature when addressing populations disproportionally impacted by the current situation. This commentary aims to add a new perspective to the current literature by specifically exploring factors that may contribute to the high rates of COVID-19 among South Asian communities in Canada.

An interview with medical student Ashley Yang.

Below are some things that service providers need to be aware of when accessing and treating clients and families from the Chinese culture, though keeping in mind that every Chinese individual and family is also unique in their own ways.

As immigrants, Asian Americans as any other group, experience emotional and behavioral problems. They tend to underuse services unless they are culturally and linguistically compatible.

The following snapshot aims to highlight how Anti-Black racism and systemic discrimination are key drivers of health inequalities faced by diverse Black Canadian communities.

Perspectives on Health & Well-Being in Black Communities in Toronto.

Links to health issues that affect Black and African Americans.

Race shouldn’t determine your health. Zip code shouldn’t change your life expectancy. Dr. Nwando Olayiwola explains how the medical profession does harm to patients by perpetuating racism & committing place-ism, ignoring place & health connections. She offers solutions for how technology & educational reform can help.

Navigating the healthcare system can be scary. But if you're a person of colour, it can be even scarier. A recent study published by Dr. Onye Nnorom painted a grim picture of what it's like to be a Black healthcare provider in Canada.

The dominating presence of racism, with its harmful effects on both mental and physical health, has been an undeniable reality for Black people for centuries.

A comment on anti-Black racism in Canada.

Transgenerational trauma is a potential barrier to achieving a healthy and holistic patient-physician relationship, particularly for Black Americans. Examination of deeply rooted historical injustices that Black patients suffer in health care and how they undermine trust can help clarify connections between historical trauma, distrust, and health outcomes. Furthering clinicians’ understanding of how daily practice can respond to Black patients’ experiences can help restore trust and mitigate racial and ethnic health inequity.

As a healthcare provider it is important to know that African Americans’ approach to sickness, disease and stress are often rooted in their cultural beliefs and values

Achieving cultural competence in the care of a patient who is a member of an ethnic or racial minority is a multifaceted project involving specific cultural knowledge as well as more general skills and attitude adjustments to advance cross-cultural communication in the clinical encounter. Using the important example of the African American patient, the authors examine relevant historical and cultural information as it relates to providing culturally competent health care.

Find practice questions, recommendations, evidence, tools and resources that will be useful to new practitioners or will serve as a refresher for more experienced health professionals.

Western medicine has begun a reckoning with its inconvenient pasts, from dethroning medical heroes to an increasing awareness of how doctors have treated colonized and enslaved populations.

Because multiple Asian American and Pacific Islander (AAPI) communities in the United States have experienced historical trauma (HT), it is important to understand HT’s impact on the well-being of members of subsequent generations. This article addresses intergenerational trauma transmission, focusing primarily on Japanese American and Southeast Asian American communities.

This article considers intergenerational trauma by drawing on the experience of a 37-year-old Black woman whose great-grandfather died as a result of involuntary involvement in the US Public Health Service Syphilis Study at Tuskegee. Although she never met her great-grandfather, the abuse, exploitation, and human rights violations he suffered at the hands of the US government profoundly influenced her health experiences. This article contextualizes her experiences in light of past medical abuse and microethics.

Learn how the effects of residential schools continue to manifest into the present day.

CBC News interviews Residential School Survivors on how Residential Schools affected survivors and their children and grandchildren.

One of the most consistent themes in testimony provided to the Truth and Reconciliation Commission of Canada (TRC) was the common experience of hunger at residential schools. In his statement to the TRC, survivor Andrew Paul spoke of the unrelenting hunger he experienced during his time at Aklavik Roman Catholic Residential School.

While research has identified racial trauma in other contexts, it is often overlooked amongst Canadian society. Racial trauma occurs as a result of an event of racism or cumulative events over time whereby an individual experiences stress and consequent mental health sequelae. Given that the BIPOC (Black, Indigenous, and/or Person of Colour) population in Canada is increasing, it is imperative to identify racial discrimination and the subsequent stress and trauma associated with being racialized in Canada, which subjects BIPOC Canadians to various forms of racism, including microaggressions.

Racism, or discrimination based on race or ethnicity, is a key contributing factor in the onset of disease. It is also responsible for increasing disparities in physical and mental health among Black, Indigenous, and people of color (BIPOC).

Native American peoples’ health is impacted by structural legacies of settler colonialism, including land dispossession, racism, and poverty. Responding with care to individuals and communities experiencing past and present traumatic stress from genocide and deeply entrenched structural violence means navigating ongoing grief, restoring self-community and human-ecological relationships, and generating cultural vibrancy.

Trauma is often viewed as an individual or interpersonal issue. This paper expands the definition of trauma to include the impact collective and structural elements on health and well-being. The need for a trauma-informed response is demonstrated, with instruction as to how to implement this type of care in order to resist re-traumatization. Three examples from healthcare settings across the nation are provided, to demonstrate the ways in which organizations are bringing forward this patient-centered, trauma-informed approach to care.

Profile and history of African and Caribbean people in Canada.

Profile and history of Asians in Canada.

Profile and history of First Nations Indigenous people in Canada.

Profile and history of Inuit in Canada.

Canada has received some positive feedback for the new and improved food guide, but how does this compare to food guides around the world? This article sets out to answer just that! This will be a journey around the world with a stop in each continent.

The new Anti-racism in Medicine Collection within MedEdPORTAL provides educators with practice-based, peer-reviewed resources to teach anti-racist knowledge and clinical skills, elevates the educational scholarship of anti-racist curricula, and aims to convene a community of collaborators dedicated to the elimination of racism within medical education.

Colour of Poverty – Colour of Change (COP-COC) is a network across Ontario working to build concrete strategies, tools and initiatives to address structural and systemic ethno-racial inequality.

A collection of resources from the College of Physicians and Surgeons of Ontario.

We provide information about cultural beliefs, medical issues and other topics related to the health care of immigrants to the US, many of whom are refugees.

The EQUIP team is committed to sharing knowledge about equity-oriented care with health care providers and organizations, to support them to adopt equity-oriented practices and provide the best possible care to their patients. Providing equity-oriented care is complex, but can start with low cost, high impact, small changes!

Sources of statistical health data as well as tips and help in finding and using the data.

The Implicit Association Test (IAT) measures attitudes and beliefs that people may be unwilling or unable to report. The IAT may be especially interesting if it shows that you have an implicit attitude that you did not know about.

A guide to honouring culture, authentic collaboration and addressing discrimination.

A toolkit from McGilll University.

Mind the Gap is a clinical handbook of signs and symptoms in Black and Brown skin. The Aim is to highlight the lack of diversity in medical literature and education.

The resources below are provided in conjunction with the Office of Minority Health's Think Cultural Health website to provide health care professionals with information, continuing education opportunities, and resources to learn about and implement CLAS and the National CLAS Standards.