Lives outside the doctor’s office cover a wide spectrum that shape whether patients are likely to be ill or well. Poverty, housing, employment, and age are just a few factors that doctors use to understand patients as people. These are called social determinants of health.
We’ve written on some of these before: poverty is the number one predictive factor of illness according to the World Health Organization, and childhood poverty can alter genetic expression for life; patients who are also homeless don’t have the same resources outside the clinic to help them recover; marginalized populations are less likely to access health care.
According to Dr. Onye Nnorom, researcher and lecturer in medicine and public health at the University of Toronto, there’s another key social determinant of health that has yet to be recognized: racism.
Currently, the notion that racial discrimination affects health is controversial, but mainly because it hasn’t been studied, says Nnorom. But it stands to reason that race can impact quality of life. Systematic oppression results in a number of disadvantages that impact families and communities. For black people in Canada, lower socioeconomic status, higher rates of family disruption by child protection services, and higher rates of unemployment coupled with lower levels of education are all documented.
First Nations communities have seen similar negative impacts of racial discrimination on health. Just last year, several communities lacked mental health services and were rocked by soaring rates of suicide across a broad range of age groups.
The Toronto Central Local Health Integration Network has started to collect racialized patient data through the Measuring Health Equity Project. Researchers like Nnorom hope to build awareness of racial barriers to health among healthcare providers and policy makers to drive change in medical practice, and obtain formal recognition of racism as a social determinant of health.
The latest research in racial health disparities will be on the agenda at the 2017 Black Physicians’ Association of Ontario Annual Health Symposium, on Feb. 25 at Mount Sinai Hospital in Toronto. Nnorom hopes that delegates will come away with stronger solutions to serving Canada’s diverse communities.
