Social determinants of health are often linked to racial inequality
Racism will shatter a person’s self-esteem, rob them of their sense of security, sink their feelings of belonging. But, according to some health authorities, racial discrimination can have a broad, damaging effect on physical health as well.
A Toronto doctor is urging public health officials to add racism to the list of social conditions that help or hinder health quality, alongside such factors as income, employment and education.
Dr. Onye Nnorom, of the University of Toronto’s Dalla Lana School of Public Health says that, in particular, Canadians who identify as black suffer worse socioeconomic outcomes than non-minorities and, as a result, have worse health outcomes.
“We really take pride in our multiculturalism and like to think of Canada as this melting pot where all children have the opportunity to reach their full potential … regardless of race or social factors,” Nnorom said.
“However right now, that’s not the case.”
Reports by the Public Health Agency of Canada list a person’s education, employment conditions, childhood development, culture, and social and physical environment as “key factors” to their health status.
Nnorom, the daughter of Nigerian and Trinidadian immigrants, points out that black Canadians have lower levels of attainment in many of those areas and risk poorer health as a result.
In Canada’s 2011 National Household Survey, black Canadians reported a median annual income of over $24,000, compared with over $31,000 for people who are not visible minorities.
In 2013, the City of Toronto reported that black and Arab Torontonians had the highest unemployment rates in the city — 12 per cent compared to just 6 per cent for non-racialized citizens.
And, after a visit to Canada in 2016, the United Nations Working Group of Experts on People of African Descent reported that “many people of African descent continue to live in poverty and poor health, have low educational attainment and are over represented at all levels of the criminal justice system.”
“Of course, when you can’t afford to eat healthy, you can’t afford to exercise … this can definitely adversely affect your health,” said Nnorom.
“For instance, if you’re diabetic and the doctor is telling you to eat fruits and vegetables, if you are struggling financially, a fancy salad is not going to be feasible for you. Nor is a gym membership.”
The stress of being targeted directly by racism can be a detriment to health too, and there are plenty of indications of institutional and interpersonal racism at play in Canada, she added:
Young black men are disproportionately likely to be stopped and carded by police. Over 40 per cent of kids in the care of the Children’s Aid Society of Toronto are black, despite the fact that black children account for up to only 8 per cent of the city’s youth as a whole.
Nnorom is not the first or only health expert to link racial bias and health.
A 2012 review by the Wellesley Institute think tank for urban health reported that black immigrants in Canada were 76 per cent more likely than other racialized groups to consider themselves unhealthy, and that some research suggested living in a “racist environment” increased the risk of illness.
In 2013, a Toronto Public Health study titled “Racialization and Health Inequities in Toronto,” acknowledged that racialized groups in Toronto generally had lower incomes and higher rates of poverty than non-racialized groups which, in turn, had an impact on health.
Black Torontonians were more likely to report being overweight or obese and to experience pain or discomfort, the study found.
Racialized groups in general were more likely to report high blood pressure.
And people who reported suffering racial discrimination were more likely to report depressive symptoms.
Toronto Public Health continues to track some of the race-based data included in its 2013 study, and had included ethnicity criteria in more recent reports.
But, Nnorom said, there is not enough data being collected in Canada that separates out different minority groups’ health outcomes.
In a recent presentation to Public Health Ontario, Nnorom said racial detriments to health were unaddressed in large part “because we don’t systematically collect nor report social or health data based on race.
Read the complete article at Toronto Star.