Tuesday, 13 October 2015 21:11

Calling for Racial Health Equity in Canada

by Lucy Slavianska in Toronto

“Racism and racial health inequities are a hidden and serious concern with detrimental consequences for all people in Canada.”

This is the position of the initiators of the 8th annual Dalla Lana student-led conference “Racial Justice Matters: Advocating for Racial Health Equity”. The conference will take place on October 23 and October 24, 2015, at the Dalla Lana School of Public Health at the University of Toronto.

“In the last two years we’ve been hearing a lot about racial issues in the U.S. and Canada,” says co chair of the student-led conference Anjum Sultana, “and there has been quite a lot of research showing that there is racism and it affects people’s health.”

Some of the recently released high profile reports that support this statement include: “Truth and Reconciliation Commission of Canada Recommendations”, “First Peoples, Second Class Treatment” and “Colour Coded Healthcare” by Wellesley Institute and “Racialization and Health Inequities in Toronto” by Toronto Public Health.

[quote align="center" color="#999999"]Sultana explains that many people of colour have lower incomes because there is racial bias in the Canadian job market, which results in lower employment and lower wages.[/quote]

“There are many different pathways that lead to negative health outcomes due to racism,” Sultana says. “One of them is poor access or lack of access to health-care services in Canada due to living in remote locations or the inability to pay – although we have a publically funded health-care system, not everything is covered.”  

Medications, eye exams, dental care and physiotherapy, for example, are not covered by the provincial insurance plans and people with low income often can’t afford them. Sultana explains that many people of colour have lower incomes because there is racial bias in the Canadian job market, which results in lower employment and lower wages.

Impacts on immigrants of colour, refugees

The same tendency exists among new immigrants from many countries. Even though they might come to Canada with high education and qualifications, their credentials might not be recognized. 

Also, they often face barriers like lack of Canadian experience, lack of trust and others. As a result new immigrants can be underemployed, do low paid and health hazard jobs to cover their basic expenses and cannot afford medication and other paid health care services. 

“As for the ‘healthy immigrant effect,’” Sultana explains, “the tendency that new immigrants are generally healthier than Canadian-born people, but their health declines as their years in Canada increase, research shows that the health of the immigrants of colour declines faster and gets worse than the health of the Europeans and Americans.”

[quote align="center" color="#999999"]"[R]esearch shows that the health of the immigrants of colour declines faster and gets worse than the health of the Europeans and Americans.”[/quote]

Even more critical is the situation of the refugees in Canada. “In the [recent] years there were a lot of cuts in refugee health care,” Sultana says. “And now refugees, many of whom are of colour and racialized, are receiving less and lower quality of health care.”  

“Not only [is] the poor access to health care affecting the people of colour and racialized patients,” Sultana says. “It is also the quality of treatment they get in the health-care institutions. There is lot of bias there, especially against the indigenous people.”

Sultana cites Brian Sinclair as an example. Sinclair, an indigenous person, went to an emergency department in Winnipeg with a treatable infection. After waiting in his wheelchair for 34 hours, he died without receiving medical help.

“Because of his [indigenous] background, he was thought to be drunk and not really sick and this resulted in his death,” Sultana explains. “This is just one case, but there are many other cases where institutions don’t provide the same quality of health care to everybody.”

Urgent need for action

“Considering this growing evidence of the presence and role of racism in our health-care system,” Sultana says, “we at the Dalla Lana School of Public Health think that there is an urgent need of actions – because these issues are impacting the lives of so many people. We have to be proactive in our efforts to put an end to racism, especially now, when Canada is becoming more and more diverse.”

[quote align="center" color="#999999"]"We have to be proactive in our efforts to put an end to racism, especially now, when Canada is becoming more and more diverse.”[/quote]

The conference at The University of Toronto aims to raise awareness about the findings of the newest research and to facilitate knowledge exchange between organizations, researchers and individuals working on the issues of racism and health. 

Also, the Dalla Lana School of Public Health strives to create opportunities for developing innovation collaborations locally and to empower participants to apply the learned knowledge into future projects on reducing the negative impact of racism in all forms.

Two initiatives Sultana strongly supports are including anti-racism training in the curriculum of medical schools in Canada and organizing anti-racism training at health-care institutions.

“Mount Sinai Hospital and a couple of other hospitals are looking at such training,” she says.  “We all have stereotypes that we may not even be aware of, and one way to uncover them is to go to training and start talking about them. Discussions would help health-care professionals become aware of their stereotypes and help them stop acting according to them.”

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Published in Health

by Peter Uduehi (@kogibobo) in Toronto

From the fight against radicalization and professional roadblocks to the question of whether a Black police chief would have any impact in Toronto, here are some recent headlines in the African-Canadian diaspora media.                             

Radicals Have No Chance With Our Youth: Toronto's Somali Community

Somalis in Toronto are not taking chances. Neither will they take a wait-and-see approach.

Tired of reports of how Jihadist terrorists have successfully recruited African youths in the U.S. state of Minnesota, Kenya and several European countries, community activist Jibril Muhammed told the African World News, “We cannot pretend that our children in Canada could not be influenced by these crazy people who call themselves Muslims. We are aware of how terrorist groups like Al-Shabaab and ISIS have poisoned the minds of innocent Somali and other African youths everywhere they can find them.”

[quote align="center" color="#999999"]Canada has been good to us and any terrorist trying to harm this country has no chance to use our kids against it.” - Mohammed Abdi, community activist[/quote]

Muhammed, who is also a former coordinator of many Somali community groups, said several organizations and individuals in the Somali community are working with the RCMP, the police and their parliamentarians in the Toronto area. “We have to protect our children against these bad eggs,” he says.

Another community activist, Mohammed Abdi, concurs. “Canada has been good to us and any terrorist trying to harm this country has no chance to use our kids against it. On my part, I am constantly educating my teenage children about what is the right Islam,” he explains. “I tell them always that the ISIS and Boko Haram and Al-Shabaab people they see on television are practising the wrong Islam.”

Will a Black Police Chief Really Make a Difference?

Writing in Pride News Magazine, educator and community organizer Ajamu Nangwaya says that simply having a Black police chief at the helm in Toronto is no cure for the poor relations between the force and the city’s African-Canadian community.

The organizer with the Toronto-based Network for the Elimination of Police Violence argues it’s like saying that the soured relations between American Blacks and the police would improve just because a Black president, Barack Obama, was elected the president of the United States.

[quote align="center" color="#999999"]“For a sobering dose of reality about race, class and policing, we may look at the behaviour of the police in major American cities that have or had African-American police chiefs or at police violence in global South countries such as Nigeria, South Africa, Brazil, Haiti, Kenya and Jamaica.” - Ajamu Nangwaya, educator and community organizer[/quote] 

He adds: “For a sobering dose of reality about race, class and policing, we may look at the behaviour of the police in major American cities that have or had African-American police chiefs or at police violence in global South countries such as Nigeria, South Africa, Brazil, Haiti, Kenya and Jamaica,” stressing that police-versus-society issues are institutionalized matters. 

Taking a swipe at those who are now calling for either deputy chiefs Peter Sloly (pictured to the left) and Mark Saunders (two African-Canadians in the Toronto Police Service) to replace the outgoing chief,  Nangwaya doubts that any police office that has successfully gone up the ladder would not belong to the same systemic ideology from which they emerged. “To what extent are we realistically expecting an African-Canadian police chief to be more committed to fighting institutional racism than a white one? Deputy Chiefs Peter Sloly and Mark Saunders have not made it this far up the organizational ladder, because of their tendency to ‘comfort the afflicted and afflict the comfortable,’” he writes. 

Why African Professionals Make Career Advancements Later in Canada

Many new African immigrants to Canada are often surprised to find themselves shut out of jobs in their professional disciplines.

So, not surprisingly, many African graduate and post-graduate degree holders end up driving taxis or taking menial jobs to make a living. The question is, why do newly arrived African professional immigrants to Canada make inroads to their chosen professions late?

Dr. Adeleye King (pictured to right), executive director of the Canadian Institute of Leadership and Development (Africa), told African World News the reasons are both professionally demanding and personal. He says when African professionals first come to the country as immigrants, they are shocked to learn that they must do more learning in their fields, “because Canada requires a different level of certification and designation from the ones in Africa.”

“Certain professions like engineering, for example, require a designation before you can be accepted for work as an engineer. It’s different in Africa where you are required only to be certified,” King explains. “[T]he same applies to other professions.”

King says that personal issues also prevent African professionals from making quick inroads into the Canadian marketplace. One issue is that many don’t do enough research about Canada before coming into the country. “If they did,” he says, “they would know exactly the type of skills needed to survive with their professional know-how.” He says it’s important to plan ahead before immigrating and, once here, “never lose concentration of why [you] are here, don’t straddle your life between here and the one you just left.”                                                                                                                            

Education Funding Cut May Negatively Impact African Nova Scotians

Recent cuts in funding to the Council on African Canadian Education (CACE) by Nova Scotia’s ministry of education may severely affect learning standards for Africans in the province, says the organization’s chairwoman Alma Johnston-Tynes.

[quote align="center" color="#999999"]“The lack of staff and resources will have a detrimental impact on CACE’s ability to identify and meet the needs of African Nova Scotian learners.” - Alma Johnston-Tynes, Council on African Canadian Education[/quote]

“The lack of staff and resources will have a detrimental impact on CACE’s ability to identify and meet the needs of African Nova Scotian learners and to fulfil its mandate under the Education Act, which is to monitor and continually analyze the policies of the Department of Education with respect to the needs of Black learners,” she said in a statement reported by the African Nova Scotian News.

The axe comes as education minister Karen Casey (pictured to left) announced that staff funding to CACE will no longer continue because of an audit that, “raised questions about the body’s governance and financial situation.” Casey described the findings as “very troubling.”

CACE was set up in 1996, after race riots in 1989, and following findings that not enough attention was being paid to improving standards for African and Black school children in the province. The council’s focus was to advise the education ministry on how to improve learning in African Nova Scotian communities, after a recent statistic showing that while reading comprehension test scores for third-graders in the Halifax regional school board was 70 per cent, it was particularly lower for African students at 54 per cent.

Immigrants Change Diet After Arriving in Canada

report by Statistics Canada cites studies that show immigrants who change their traditional diet after arriving in Canada tend to become less healthy later. Overall, the studies show, newly arrived immigrants to Canada had lower mortality rates than the Canadian-born, and also reported lower levels of fair or poor health. Those mortality rates tended to rise, the further removed immigrants were from their arrival in Canada, as did the reported levels of fair or poor health. 

Tanzanian-born Toronto resident Dr. Wasira Bokore, a family physician, told African World News that generally the African immigrant succumbs to, “a new environment where time is limited for cooking your meals and begins to adopt new eating habits, eating burgers, fast foods and fatty foods and these things are not good for your health.” She adds that matters are made worse when, “an exercise regimen is absent in one’s daily existence.”


Peter Uduehi is a journalist and publisher of the African World News in Toronto.

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Published in Africa

[message_box title="Caption:" color="red" show_close="Yes/No"]NCM contributor Maria Assaf spoke with Ryerson's Dr. Usha George about immigrant health disparity[/message_box]

by Maria Assaf

A struggle to find employment and a lack of understanding of the medical system are the main reasons for the “healthy immigrant effect,” a phenomenon of new immigrants’ health decline within their first five years of arriving to Canada, said Maya Roy, executive director of Newcomer Women’s Services, at the Immigrant and Racialized Women’s Health (IRWH) project conference on February 21 at Ryerson University’s Ted Rogers School of Management.

The event brought together researchers from Ryerson, York and the University of Toronto who, along with healthcare practitioners, community activists and policy makers, shared their ideas with the public on how to improve immigrant women’s health in Ontario.

“When immigrants arrive in Canada, [they] say…‘I’m in good health.’ Or their health state is seen as good. Over four or five years of being in Canada or even much later, that good health state kind of declines one or two points to modest health,” said Dr. Usha George, dean of Ryerson’s faculty of social work and one of the project members. “There is a lot of evidence indicating that minority populations have less access to health, more diseases and the severity of their diseases is also very high compared to the normal population.”

The cause, she explained, is “mainly lifestyle changes and a lack of understanding about the system itself and access to health care and even the quality of healthcare they receive.”

Declining immigrant health

Part of the problem, said Roy, is that government health promotional materials are geared towards middle-class Canadian-born women and do not take into consideration the social and economic landscape of most Canadian new immigrants.

Newcomers, who, according to the panel account for 12 per cent of Toronto’s population, have lower incomes, said Monica Campbell, director of Healthy Public Policy. They also have a higher unemployment rate and are paid less than native Canadians in similar jobs – with the gap being much worse in Toronto, Vancouver and Montreal, the top three immigrant destinations.

Immigrants who are concerned about finding suitable employment don’t have the time to join a sports team or exercise regularly, said Roy, who summarized new immigrants’ views on this matter with the slogan: “less jogging, more jobs.”

She said new immigrants need to be further included in social and political life. A lot of the time, immigrants’ professional qualifications from their native countries are not recognized in Canada, leading to underemployment. 

Campbell said once they settle in Canada and their incomes improve, immigrants’ activity levels and overall health increase again.

[quote align="center" color="#999999"]Immigrants who are concerned about finding suitable employment don’t have the time to join a sports team or exercise regularly, said Roy, who summarized new immigrants’ views on this matter with the slogan: “less jogging, more jobs.”[/quote]

Analyzing health disparity

The IRWH project was funded by the province of Ontario. Three years ago, a team comprised of professionals from all over Ontario set out to analyze and summarize academic literature to find out the causes behind health disparity among new immigrants in comparison to those born in Canada. 

The conference included 12 speakers, three moderators and 175 attendees from across the province. Conferences like this one allow non-industry professionals to get access to academic research about important health matters.

“We believe that health literacy, that is knowing much more about health issues, will enable people to manage their health better,” said George.

Most of the speakers agreed that the three-month Ontario Health Insurance Plan (OHIP) wait for new immigrants should be eliminated. In Ontario, most arriving or former residents returning to the province have to wait three months before they can get their healthcare covered under OHIP (there are some exemptions).

A great number of immigrant women are of childbearing age, said Campbell, so a lot of them need antenatal care. This makes the three-month waiting period difficult.

Manavi Handa, assistant professor at the Midwifery Education Program at Ryerson, said non-status immigrants who do not get any health care coverage experience the greatest difficulties.

Difficulties accessing health services also increases the rates of mental health problems for both the mother and the offspring. “Post-partum and antenatal depression can cause long-term consequences for children,” she said.

Another problem, she mentioned, is that children of uninsured parents are not often taken to health care facilities when needed. This can happen because of parental fears and misunderstanding of the policy.

The highest dollar expenditure in Canadian health care is on post-natal care, said Handa, and increasing spending on pre-natal care is not only humane, but also financially beneficial for Ontario’s health care system. “Every one dollar spent on prenatal care saves two to three dollars to the health care system,” she said.

Campbell said the province also needs to deal with important issues such as racism and better healthcare for refugees. She said 67% of people in Toronto have experienced racial discrimination and this can cause depressive symptoms, which, along with work and life stress, can cause mental health complications for new immigrants.

[quote align="center" color="#999999"]67% of people in Toronto have experienced racial discrimination and this can cause depressive symptoms, which, along with work and life stress, can cause mental health complications for new immigrants.[/quote]

Health discrepancies

Cultural differences can also have serious health implications. About 15 years ago, George conducted a study about mammograms for immigrant women. “We found that family doctors were reluctant to prescribe mammograms for immigrant women simply because they thought that they would not go anyway, so why prescribe it,” she said. “They make some assumptions around their health beliefs or their health practices and therefore [they] may not provide the kind of prescriptions that are required for preventive kind of healthcare.”

Dipti Purbhoo from Toronto central’s Community Care Access Centre (CCAC) talked about the challenges and needs of providing health care in Toronto, one of the most diverse cities in the world.

She explained it is important to focus on prevention of diseases like TB, since the incidence rate of this disease in Toronto is three times higher than the provincial average. HIV/AIDS rate in Toronto is 11.3 times higher than Ontario’s average. 

Purbhoo also talked about the value of home-care workers and their need for higher wages, pensions and benefits. This mostly female workforce helps bathe seniors, clean homes and prepare meals for the city’s elderly for very little pay – $15.57/hour - with no benefits. They make less money than cleaners, so a lot of them have to take up cleaning jobs on the side to make ends meet.

Near the lunch break, Roy presented an emotional video about issues affecting elderly women in Canada. The video showed grandmothers from new immigrant communities talking about their desires.

A lot of their needs included access to cultural food, getting access to free transportation, feeling valued and respected by the youth and being independent.

Addressing the health needs of immigrant women is vital to ensuring a healthy province, and ultimately, a healthy country. 

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Published in Health

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