A family doctor who helped create an anti-Black racism course for health professionals says she hopes participants will 鈥渦nlearn鈥� long-standing discriminatory practices that contribute to inequitable care for a vulnerable group.
Dr. Onye Nnorom, co-founder of the Black Health Education Collaborative based at the University of Toronto and Halifax鈥檚 Dalhousie University, said the online course, to be launched Thursday, addresses gaps in medical education by exploring how everyday systemic biases affect the health of a diverse community.
鈥淢ost of the time, it鈥檚 not going to be a physician who actually says something directly racist, or a slur or something like that. It鈥檚 simply a subtle lack of empathy, perhaps not going out of their way to provide resources. Or sometimes assumptions are made about a person or their level of education,鈥� said Nnorom, an assistant professor at the University of Toronto鈥檚 Dalla Lana School of Public Health and Temerty Faculty of Medicine.
Nnorom (pronounced like 鈥渘o rum鈥�) said families are often 鈥渉yper vigilant鈥� about any neglect or discrimination their loved ones may face while in hospital.
鈥淥ne of the things that is difficult about racism in health care is that you鈥檙e not always sure if the way you鈥檙e treated, or your family is being treated, because it鈥檚 so subtle, is due to racism.鈥�
Nnorom said she spent a lot of time by her father鈥檚 bedside in 2015 when he had surgery for a hemorrhagic stroke related to dementia because she wanted to protect him from harm if necessary.
The six-hour, self-paced, online course was developed by the collaborative with partial funding from the Canadian Institutes of Health Research. It includes eight modules that cover topics including criminal justice, child welfare and the legacy of slavery.
Available on the collaborative鈥檚 website, the voluntary course costs between $275 and $350, depending on the number of registrants, and results in a certificate.
Nnorom said the collaborative is now working with the Medical Council of Canada to include questions about Black health on future exams. All medical students must pass the exam before they can work as doctors.
鈥淪tudents will have to learn about Black health for the first time,鈥� she said of the plan, adding that anti-Black racism is not part of all medical school curriculums.
It could also be a resource for medical schools, which set their own curriculums to address racism against other groups and be used as part of a continuing education component for administrators, nurses, doctors, and public health officials, she said.
Harmful anti-Black misconceptions and social structures affect health in ways that could include high blood pressure and chronic diseases at an earlier age, she said.
鈥淚t鈥檚 the stress that鈥檚 put on us that is impacting our health and not our faulty genes. We know that for high blood pressure, we see higher numbers for Black people, Indigenous people, South Asian people. Are you telling me that we all have the same mutation? Or are we experiencing similar situations? If it鈥檚 a situation, that鈥檚 injustice, and we can do something about it,鈥� she said.
鈥淲e want health-care providers to understand it鈥檚 the situation that we鈥檙e living in everyday. And when we come to the hospital, it鈥檚 that much worse. We are put into another situation of racism.鈥�
A Public Health Agency of Canada report released four years ago said discrimination against Black communities is deeply entrenched in the country鈥檚 institutions, policies and practices due to European colonization in Africa and the legacy of slavery, which was legal in Canada until 1834.
Race-based data is not collected in Canada to help show the predominance of various conditions on certain groups that may be due to social determinants of health.
A study published in the Canadian Medical Association Journal in 2016 found that nearly nine per cent of babies born to Black women were preterm between 2004 and 2006, compared to nearly six per cent for white women.
Nnorom said that type of data could help doctors more closely monitor the health of pregnant Black women who are also at greater risk of unemployment and housing inequity.
OmiSoore Dryden, an expert in Black studies at Dalhousie University鈥檚 faculty of medicine and a contributor to the course, said she saw several specialists for pain several years ago but some assumed she had sickle cell disease because it is more common among Black people.
However, she was eventually diagnosed with Crohn鈥檚 disease.
鈥淚t was the idea that because I wasn鈥檛 white or Jewish that meant it couldn鈥檛 be Crohn鈥檚, it had to be something else. This is where we see an over-reliance on race biology, or the idea that certain races, or certain people have specific types of illnesses.鈥�
Dryden said she has lived in cities including Victoria, Vancouver, Toronto and Halifax, and has heard of negative experiences that other Black people have also faced there in the health-care system.
鈥淚 think all of us could come up with a number of experiences, whether it was delayed diagnoses, inappropriate levels of pain management or being denied care.鈥�
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