Building an Agenda for Health Equity in Black Communities

RACE AND HEALTH SENATOR WANDA THOMAS BERNARD JUNE 13, 2019

ADVANCING AN AGENDA FOR HEALTH EQUITY IN BLACK COMMUNITIES

AGENDA • African Nova Scotians • Major Issues in Health • Representation matters • Promising Policy Mechanisms

DESMOND FAMILY TRAGEDY • Intersection of race and mental health • Compounding trauma • Self-referred to hospital • discharged the day before murder-suicide

RACE AS A SOCIAL DETERMINANT OF HEALTH

ACCESS TO HEALTHCARE EDUCATION

EMPLOYMENT/ INCOME

HOUSING

HEALTH

PHYSICAL ENVIRONMENT

MAJOR HEALTH ISSUES • Diabetes • Cancer • Heart disease • Hypertension • Mental health

BARRIERS TO HEALTHCARE • Misdiagnosis • Overt and covert racism • Lack of disaggregated data • Unconscious bias

PROMISING POLICY MECHANISMS

SOCIAL DETERMINANTS

OF HEALTH

ANTI-RACISM TRAINING – INSTITUTIONAL AND CONTINUING EDUCATION

FOCUS ON HAVING AFRICAN CANADIANS AT THE CORE OF HEALTH CARE

REPRESENTATION MATTERS

FRONTLINE

BOARDS RESEARCH

AT THE CORE OF POLICY ANALYSIS: RACE EQUITY LENS

INTERSECTIONALITY

INPUT FROM AFRICAN CANADIANS

ON CRITICAL HOPE:

“HOPE HAS THE POWER TO RESTORE, REGENERATE AND HEAL.” -RACE AND WELLBEING

CONTACT WANDATHOMAS.BERNARD@SEN.PARL.GC.CA

Health Equity and Black Gay Men Tyler Boyce Anonymous HIV Testing Outreach Coordinator Somerset West CHC

@TylerKBoyc e

Have you ever heard?

What kind of program do Black Gay Men want to see?

What are the needs of Black Gay Men? How do I get Black Gay Men to show up to my program?

How do I get Black Gay Men to apply to work at my CHC? How do I ensure that my my programs are culturally relevant and safe for Black Gay Men?

Context

But don’t all Gay Men have the same needs?

“It has been awful. I should not be surprised that just because we happen to share a sexuality that it would absolve them or cure them of all prejudices that exist" while also describing transphobia and homophobia in the Somali-American community as being normal and to be expected”

Anti-Black Racism

Homophobia

Attitudes: Hate Crimes in Canada In 2017, more than half of all hate crimes based on the victim’s sexual orientation were violent; representing more violent hate crimes than any other group Similarly, hate crimes against the Black community are the most common type of race or ethnicity related hate crime in Canada Further, 2017 marked a 50% increase in hate crimes targeting Black Canadians Living at the intersection of Black and Gay?

HIV Black communities in Ontario account for 24.6% of all new HIV diagnoses in the province Men who have sex with Men (MSM) account for 58.8% of new infections

Living at the intersection of Black and Gay?

Responses?

African, Caribbean, Black Same Gender Loving Men’s Dialogue 2018 Hosted by ACCHO, GMSH, and Black CAP Objectives: 1. Explore key issues affecting the sexual health and wellbeing of SGL ACB men 2. Briefly review the Ontario Black Gay Men’s Summit (2010) and other previous and current relevant initiatives to identify whether and how identified priorities remain relevant today; 3. Identify current priorities and key avenues for action to address identified priorities

1. We must be the narrators of our own experiences Culture and Knowledge Production: -

Emphasize Storytelling Deconstruct the “white� story of pride

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Share knowledge through accessible mediums: filmmaking, visual art, and poetry Invest in Community Based Participatory Research led by and centred on Black Gay Men

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2. Sexual Health is about more than STIs and HIV Sexual Health and Pleasure: -

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Include relationships, pleasure, and intimacy Address how power affects sexual decision-making

Train health providers to see Black Gay Men beyond the lens of seuxal illness Invest in Community Based Participatory Research led by and centred on Black Gay Men

3. Our substance use deserves harm reduction too Substance Use: -

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Investigate substance abuse as a symptom of oppression: employment discrimination, insecure housing, settlement issues, etc.

Dismantle stigma around substance use

Invest in Community Based Participatory Research Commit to learning anti-racism AND equity

4. Mentorship is essential Mentorship: -

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Foster intergenerational knowledge sharing Centre Black Gay Men as holistically healthy

Support community archival practices through film and art: Stories of pain, oppression, resilience, and joy Leverage social media such as Facebook groups as a safe space for intergenerational conversation and connection

5. We are stronger together Black Gay Men’s Network of Ontario -

Create space for Black Gay Men to share info, connect, build community, set their own agenda, and archive experiences

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Leverage organizational resources to support this initiative Protect the autonomy of grassroots initiatives

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Thank you! @TylerKBoyce

Mandate & Commitment The Mandate of Women’s Health in Women’s Hands (WHIWH) Community Health Centre is to provide primary healthcare to racialized women from the African, Caribbean, Latin American and South Asian communities in Toronto and surrounding municipalities.

Canadian Systems of Oppression impacting the health of young Black Womxn:     

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Anti-Black Racism - (in every social institution, including but not limited to healthcare, education, child welfare etc.)

Sexism, Patriarchy, & Misogyny Homophobia & Transphobia Islamphobia Poverty - Lack of adequate housing, & food insecurity Intimate, Community, Systemic & Structural Violence Migration Interactions with the law Abelism Ageism

Building a Black-Canadian Health Agenda What are the practices we will utilize to operationalize an intersectional Black Health agenda ?

Considerations for building a Black-Canadian lens     

Interventions, policy, and programs centered on the SDOH on local, provincial, and federal levels Cultural safety Community engagement Reflective representation of medical doctors, researchers, and management Addressing Anti-Black racism amongst institutions

Challenges:   

Eurocentric Medical Model Funding Meaningful support and engagement from community partners