From the classroom to the delivery room, future health care professionals must work to combat racial disparities in health care

By: Danoya Thomas, Opinion Contributor

CW: Medical racism, historical trauma, neglect in health care

The strength of a Black woman is not a result of genetics or natural processes. It emerged from the need to overcome systemic racism, biases and inequities that stem from a history of slavery and institutionalized racism—issues that permeate every aspect of our lives. This is especially apparent within health care, where we consistently experience neglect and poor treatment, negatively impacting both quality of life and life expectancy.

To understand present-day struggles, a look to the past is necessary. Parts of modern-day gynecology were built on the exploitation of slavery, when J. Marion Sims’ experiments on the bodies of Black women were performed without consent, enabled by the subjugation of bondage. These experiments were done to cure vesicovaginal fistulas.

However, the added horror of these experiences was in the absence of anesthesia for Black women, while their white counterparts received both anesthesia and consent.

The effects of this did not end with Sims’ experiments; medical racism has been propelled into the 20th and 21st centuries, shaping health care policies that dictate bias training, diverse hiring, treatment guidelines, insurance coverage and many other factors that continue to affect Black patient health.

This message is for anyone entering a health care profession; acknowledging this history is about more than dwelling on past injustices. It’s about using this knowledge to fuel you. It’s about using it to examine how subtle yet significant your contributions will be in addressing and minimizing the shortcomings of racism in a health care system that you will soon be a part of.

According to a CBC documentary article by Amanda Parris, little data is collected in Canada on the experiences of Black patients in health care.

“Unfortunately, these experts on the front lines in Canada don't have the stats to back up their day-to-day observations because in most of the country (except for Nova Scotia), there is a refusal to track race-based health data,” wrote Parris.

Refusing to collect race-based health data makes it increasingly difficult to identify, measure and address health disparities. As a result, this impedes progress and advocacy for change.

The absence of publicly accessible data further highlights the systemic neglect faced by Black women. Keeping crucial information hidden prevents necessary awareness and action, further perpetuating the reduced resources and attention needed to create safe hospitals for us and reinforcing informational barriers.

The relationship between patients and practitioners significantly influences how Black women experience treatment when they are at their most vulnerable. Because of this, doctors, nurses, physician assistants, therapists, midwives and all others involved in patient care play a major role in Black health advocacy and in the treatment Black patients receive.

Racial bias leads to the dismissal of pain in Black patients. But for Black women, racial stereotypes further compound this neglect, allowing sexism and racism to intersect in life-threatening ways.

Pulmonary embolism is one of many fatal post-labour complications often disregarded in Black women, as seen in Serena Williams’ harrowing experience after childbirth. Despite a history of the condition, her medical team dismissed her symptoms, even as she lost consciousness and coughed so violently that it tore her stitches.

Yet, it wasn’t these life-threatening signs that led to proper care. Only when she demanded specific tests did doctors finally act. Shockingly, the very professionals with decades of training to save lives failed her—until she strongly advocated for the care she knew she needed.

To McMaster students aspiring to enter health care, this is a terrible reality that you must work to change. The responsibility lies not only with policymakers or hospital administration, but also with the individuals caring for patients directly.

Listening, believing and taking Black patients’ concerns seriously, the first time, could be the difference between life and death. As future practitioners, will you be part of the problem or the solution?

Listening, believing and taking Black patients’ concerns seriously, the first time, could be the difference between life and death.

For now, students can educate themselves on medical racism by going beyond the rudimentary information covered in classrooms. This means seeking out further readings, engaging with Black health advocacy groups, challenging biases through advocacy with MSU’s education department and more.

Call out professors and peers who perpetuate misinformation and biases, because as the saying goes, “First, do no harm.” You must be willing to confront racism wherever it appears.

"First, do no harm.” You must be willing to confront racism wherever it appears.

Demolition of the Hamilton board of education’s headquarters began on Aug. 1, the day that McMaster University took possession of the property. The plot of land at 100 Main St. W. will be the location of a McMaster family health centre. The project is going ahead despite vocal opposition from community members, who felt that the 46-year-old Education Centre building had historical significance and the potential for future use.

 

After months of debate, Hamilton’s City Council is pushing forward with plans for a joint Hamilton-McMaster venture on a new health campus, which will replace the Hamilton-Wentworth District School Board headquarters at Main and Bay Street. The building would also house some of the City’s public health offices.

Though the Board has agreed to relocate to a spot on the Hamilton mountain, some residents weren’t pleased when they heard the board of education’s headquarters might be demolished for the cause.

Former Hamilton Spectator columnist Paul Wilson, architect Joseph Singer, and Hamilton resident Matt Jelly are among those who spoke out that the university should look at other available properties. In 2008, the Municipal Heritage Committee urged the City to consider the heritage value of the 44-year-old headquarters, considered by many to be a modern architectural gem. The Education Centre does not, however, have a formal heritage designation.

Following a vote last month, public health staff will move into the Robert Thomson building, above Jackson Square, with the health campus holding some public health offices as well when it is complete.

The 195,000 square-foot campus, eight years in the making, was approved by city councillors last July. The campus will integrate research, education, and family medicine while playing a role in downtown renewal.

“The new campus will be a centre for student learning, research, patient care and training,” said Gord Arbeau, director of public and community relations at McMaster.

“It will accommodate about 4,000 students, many of whom will be in the faculty of health sciences, with others participating in events and conferences.”

Now that demolition plans have    been finalized, the school board will preserve some key features of the Education Centre, including a statue donated by Dutch Canadians in 1967, a frieze above the building’s main entrance depicting various occupations, and a time capsule buried under the cornerstone of the building.

In addition to the city’s partnership with McMaster on the campus, the city had been trying to consolidate 460 public health employees in a new downtown location since 2005. The school board had planned to sublet part of the Robert Thomson Building to serve as temporary headquarters, but city staff wanted to use most of the space to accommodate public health workers.

Tense negotiations between city staff and councillors about a “swing space” for school board employees put the deal with McMaster on hold until the end of March, when it was resolved that the campus would be built at 100 Main Street W.

As school board employees wait for new headquarters to be built at Crestwood school, they will move to offices in the Robert Thomson Building,  Stelco Tower, and Standard Life Building.
Last month, councillors finally ended the debate with city staff, voting 8-5 to consolidate public health staff in the Robert Thomson Building. While not the cheapest option, the space would provide more comfortable quarters for most of the city’s public health workers.

Construction of the downtown health campus will begin later this year. The building must be ready for use by July 4, 2014 in order to secure $19 million in funding by the province.

The campus is expected to accommodate 54,000 patient visits per year and grant physician access to 15,000 Hamiltonians currently without family doctors. It is also projected to create 650 jobs during construction and bring 450 McMaster employees to the downtown core.