HEALTH INEQUITIES
Chronic Disease
Black people experience disparities in health outcomes when compared to the Canadian population at large. Heart disease and stroke are among the leading causes of death among Canadians and Black communities are among those with the greatest increases in risk factors for heart disease and stroke such as hypertension, diabetes, chronic stress, and obesity. These conditions can impact quality of life and also contribute to higher mortality rates.
Although there are some conditions that are inherited at greater rates in some ethnic groups, such as sickle cell disease, the majority of chronic illnesses have many different contributing factors including – social determinants of health such as access to health care, support networks, education and stress.
One ongoing stressor is Anti-Black Racism, which we believe is a major contributing factor to many of the disparities in health that Black people experience. Living with both societal and personal racism has been shown to worsen multiple chronic illnesses.
An Ontario study determined that from 2001 to 2012:
- Diabetes rates doubled among Black women from 6% to 12%.
- Black women have a higher risk of developing cardiovascular disease than Black men.
- Among ethnic communities, Black women have had the most drastic increase in rates of high blood pressure increasing from 20% in 2001 to 27% in 2012.
Our long-term goal is to reduce the higher rates of chronic illness in Black Canadians. We aim to first engage in research being done to provide accurate data about the nature and causes of these rate differences. Then apply information to ensure that government and health care providers fund and address the root causes of the illness. Then we must empower our communities to take control of their own health outcomes and care.
To accomplish this goal we need to have all members of the health care spectrum involved in the conversation, from those affected by chronic illness, to care givers to those seeking long-term cures. We have gained many advances in equality in other aspects of our collective lives. This is an area where we can and will also excel.
Mental Health & Addictions
Mental health and addictions in Canada’s African, Caribbean, and Black population is profoundly misunderstood and stigmatized which can pose a barrier to raising awareness of its long-term impact on population and patient health outcomes. Social issues such as anti-Black racism, sexism, poor education and employment rates, inadequate housing, and poverty are major contributing factors to this phenomenon. Mental health and addictions can impact quality of life, lifespan, personal relationships, and chronic disease risk which can affect the person’s level of self-esteem and self-worth.
Currently, one of the main challenges to capturing the full extent of the problem and identifying effective solutions is the lack of race-based data. In addition, the absence of culturally appropriate services and resources that specifically target Black communities within Canada results in many people struggling alone and in silence. The shortage of African, Caribbean, and Black practitioners and community workers who are versed in the unique needs and challenges within this population further compounds the problem.
From Ontario based studies we know that:
- People of Caribbean, East and West African origin in Ontario have 60% increased risk of psychosis
- Black Ontarians of Caribbean descent have 2 times the delay in getting to evidence based services than those of white European descent
- Black Ontarians experience a higher level aversive pathways to care (emergency room, ambulance or police) when compared to those of white European descent
- Black Ontarians experience higher rates of restraint and confinement under the care of the mental health and addictions system
Black Health Alliance is committed to reducing racial differences in mental health outcomes for the Canadian Black population by working with the community, decision-makers, and civic allies who are on the same mission. In order to build upon previous work we need to enhance our understanding of what historical factors have contributed to this crisis, the impacts on our overall health and well-being, and what challenges we confront in addressing the issue. As part of our long-term strategy, we will collect race-based data that will enable us to gain these critical insights. This prepares us to inform decision makers of our distinct needs and advocate for targeted mental health and addictions resources, programs, and services. Resources should be funneled into awareness-raising initiatives to encourage community members to have the difficult conversations and eliminate the stigma that is associated with reaching out for help. Moreover, it is important that in the process of community planning we consider the link between better mental health and addictions and the social determinants of health and disease. Furthermore, African, Caribbean, and Black communities can benefit from culturally appropriate programs that take into account factors that shape our perspectives on mental health such as place of origin, religion, culture, age, gender, education level, and social environment. There is still a great deal of work to be done, but we remain dedicated and hopeful for the future.
*Chiu M, Maclagan LC, Tu JV, et al. Temporal trends in cardiovascular disease risk factors among white, South Asian, Chinese and black groups in Ontario, Canada, 2001 to 2012: a population-based study. BMJ Open 2015;5:e007232. doi: 10.1136/bmjopen-2014-007232
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