Time to dismantle systemic anti-Black racism in medicine in Canada

On May 25, 2020, George Floyd, an unarmed Black man, was murdered in the United States by White police officer Derek Chauvin who, in the course of arresting Mr. Floyd for allegedly using a counterfeit 20-dollar bill, knelt on his neck for almost 9 minutes. Mr. Floyd repeatedly said, “I can’t breathe” (www.nytimes.com/2020/05/31/us/george-floyd-investigation.html). The video of this event, released on social media the next day, started a new chapter in history, sparking protests worldwide that demanded justice and an end to anti-Black racism. In response, the Toronto Board of Health declared anti-Black racism a public health crisis (www.cbc.ca/news/canada/toronto/board-of-health-anti-black-racism-1.5603383), and several public health units in Ontario followed suit, acknowledging that race-based health inequities disproportionately affect Black and racialized communities. We consider the health impacts of anti-Black racism and discuss what the field of medicine must do to dismantle systemic racism in its structures and institutions.

Black people comprise 3.5% of Canada’s total population and about 43% of Black people in Canada are Canadian born.1 In Nova Scotia, there are large, centuries-old communities, including descendants of people who were enslaved in Canada. Although slavery was abolished in what was to become Canada in 1831, it was a foundational institution in the building of the nation.2,3 Black Canadians also represent diverse immigrant communities.

Systemic racism (also referred to as structural or institutionalized racism) refers to “the processes of racism that are embedded in laws (local, state, and federal), policies, and practices of society and its institutions that provide advantages to racial groups deemed as superior, while differentially oppressing, disadvantaging, or otherwise neglecting racial groups viewed as inferior.”4 Anti-Black racism is a specific form of racism, rooted in the history and experience of enslavement, that is targeted against Black people, people of African descent. Myths and stereotypes were created and used to justify slavery and the torture of enslaved African people, including the idea that Black people were biologically different or subhuman, less intelligent, had a greater tolerance for pain and were not to be trusted, among many others.

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