Are Black Women Worth the Effort?

This year, Emancipation month feels different to me. There’s a level of new expectancy–an urgency for real change, and I want to fully revel in it, but I feel a lingering sadness.

To quote Harriet Beecher Stowe, “A woman's health is her capital.” If so, myriads of Canadian Black women are impoverished. Many studies link income and wealth to better health outcomes: the more financially well-off you are, generally, the healthier you will be.

There is suggestive evidence that Black women in Canada are served poorly by the health system. But detailed, comprehensive race-based data to make the case are missing and not collected in this country. Having these data is a first step in advancing the health of our Black women.

The prejudice meted out to Black Canadians was referenced in a Public Health Agency of Canada 2020 study which stated that “inequities in access to … income, employment, etc … can drive inequities in health and wellbeing.” The report further notes that “...systemic discrimination and under-treatment in hospitals and other healthcare systems, are a fact that cannot be disputed. (https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health/social-determinants-inequities-black-canadians-snapshot.html)

A 2024 submission to the House of Commons Standing Committee on Health (HESA), by Salami et al, further highlights negative aspects of Black women’s health outcomes, and draws connections to our lack of earning power in the Canadian context. https://www.ourcommons.ca/Content/Committee/441/HESA/Brief/BR13066759/br-external/Jointly07-e.pdf Maternal mortality is another negative outcome highlighted. The submission notes that “data from the United States and the United Kingdom reveal a three-fold higher maternal mortality in Black women compared to their White counterparts.” (Centers for Disease Control and Prevention, 2024; MBRRACE-UK, 2024.) However, Canada has been slow to collect race-based maternal–newborn data at the population level. (Maxwell, Tunde-Byass and Wilson-Mitchell, CMAJ 2024.) These data are needed to assess the problem here and to prompt solutions.

But what does this have to do with emancipation? Suppose we look at emancipation as more than freedom from slavery. Black women deserve freedom from the risks, challenges, negative health outcomes and systemic racism of the health system.

In the early 1990’s, I volunteered on one of the now defunct Toronto District Health Council’s (TDHC) committees. TDHC, was a local voice in health planning for the city of Toronto, and an advisory agency to Ontario’s Minister of Health and Long-Term Care on the local health system. Thirty-plus years ago, determining the health needs of Black people was a challenge severely impacted by a dearth of race-based data. It is still today.

Researchers, epidemiologists, and clinicians across Canada are leading the charge to fix the gaps of collecting and using race-based data, but there’s still a long way to go. The recent Powering Equity Summit held by Wellesley Institute in May, 2024 brought together presenters from different provinces, to speak about their efforts at collecting race-based and equity data. Help them, help us, stay healthy. Anyone can take action. Organize! Create or join local health coalitions. Send letters to your federal and provincial ministers of health. Demand that Canada collect race-based disaggregated data.

Race-based data must not only be collected, they must be properly governed, stored and safe-guarded. The data have the potential to improve health outcomes for Black populations; but also to further stigmatize our community. A Data Governance Framework for Health Care Data from Black Communities affirms that “when collected and used in accordance with best practices, race-based data in health can be used to dismantle racism.”

 An excellent source for advancing health equity in the GTA is the Wellesley Institute: https://www.wellesleyinstitute.com/ See their many publications on these subjects.

Finally, we pay our taxes; let them serve us. Federally, Arielle Kayabaga is a member of HESA. Send her our demands. arielle.kayabaga@parl.gc.ca 

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Originally published in The Caribbean Camera, August 2024