The coronavirus pandemic is exposing the inequities that exist within our healthcare systems. Black people are contracting and dying of COVID-19 at extreme, disproportionate rates, and in some places, they are not being tested for the virus nearly as frequently as their non-people of colour peers. We cannot ignore how the virus is hitting the underserved black communities the hardest and how inequalities amongst racialized communities are deeply intertwined with this issue. These factors are important, but they are often missed when taking statistical modeling of COVID-19 risk factors.

The US Centers for Disease Control and Prevention found that several minority groups account for a high number of the COVID-19 cases and fatalities in the United States, but the black community, in particular, is suffering immensely. For instance, in Wisconsin, a state that is only comprised of 6 percent of black people in its total population, they account for about half of the state’s COVID-19 deaths. In Chicago, black people account for 70 percent of deaths due to COVID-19 but make up only 30 percent of its population. Furthermore, in England, according to the Office of National Statistics, black people are four times more likely to die from COVID-19 than white people. It was reported that the difference in the virus’s impact was caused by the pre-existing differences in communities’ health, wealth, education, and living arrangements. It was also discovered that after considering age, measures of self-reported health, and other socio-demographic traits, black people were almost twice as likely as white people to die from death related to COVID-19.

The gulf between health statistics of black people and non-people of colour has existed for decades and even centuries. The recent pandemic is just the latest manifestation of the pre-existing trend. The explanation as to why black people are disproportionately affected is incredibly complex. Structural inequalities have prevented black people from having access to opportunities, which has created greater economic disparities. These divisions further lead to health disparities, especially during a pandemic. Firstly, regarding housing, minority populations, particularly black people, tend to live more densely populated areas and have more people per household. Thus, this causes settings where people are unable to effectively socially distance themselves from others. Furthermore, there is a greater tendency for black people to work in jobs that are currently considered essential and front-line, which leads them to be more vulnerable and exposed to situations where social distancing is not possible. Statistics further show that they also are far less likely to have paid sick leave and enough savings to take time off. This results in a greater risk for black people to contract COVID-19. Another biggest challenge is the fact that black people start out with health outcomes that are much poorer when compared to others. For African Americans, you start with a population that is disproportionately sicker, and if it gets exposed, there will have a higher death rate. The reasons for these health inequities include lack of resources to access to proper healthcare. Many people of colour are uninsured in the United States, which does not operate under a universally, accessible healthcare system. All of these factors contribute to why black people are more likely to contract and die from COVID-19.

COVID-19 emphasizes a myriad of issues of inequalities for black communities. Understanding these complex disparities that exist within our communities is critical in order to address this issue. We need to actively seek ways to dismantle structural inequalities, systematic discrimination, and educate ourselves in order to create positive change.

https://www.nationalgeographic.com/history/2020/04/coronavirus-disproportionately-impacts-african-americans/

https://www.bbc.com/future/article/20200420-coronavirus-why-some-racial-groups-are-more-vulnerable

https://www.medpagetoday.com/infectiousdisease/covid19/86266

It is hard to express the searing injustice I feel at the state of race relations in America, Canada and around the world. Systemic racism has always been and continues to be an enduring problem within our society and I cannot begin to imagine the pain and grief that the black community is experiencing. Thinking about how many names there are to keep in our memory, how many lives have been senselessly lost, and how long justice has gone unserved has left me speechless.

The pattern of abuse we are seeing is no mistake and the fact that there has been little change despite an unspeakable number of tragedies emphasizes just how broken our institutions are.There are a myriad of topics that could be discussed, ranging from problems with Broken Windows policing, to discriminatory sentencing laws, to how explicit and subconscious biases lead to drastic black-white disparities in fatal police shootings. In writing this piece, I hope to illuminate a small fraction of the issues persistent within our legal institutions which disproportionately affect the black community and lead to a situation where there is little to no redress for police brutality.

For the past few weeks, protests have exploded across the United States and around the world seeking justice for George Floyd. Unfortunately, the recent arrest and charges laid against the Minneapolis police officer Derek Chauvin and some of his colleagues are an outlier in a system where police officers rarely ever face consequences for their actions. According to the Washington Post, in the 10-year period from 2005 to 2014, approximately 10,000 Americans were killed by police, yet only around 1.5% of the officers involved were charged. Even fewer are actually convicted.

Part of the reason why initial criminal charges are so rare is because of the close relationship between prosecutors and police; because prosecutors collaborate with police on cases, they are often reluctant to pursue cases against police officers. This is worsened by the fact that investigations often land within the same police department from which the officer worked, representing a major conflict of interest. With criminal charges inaccessible, civil action is often one of the only means of redress left.

However, civil action has also proven to be a difficult route for justice because of a doctrine known as “qualified immunity.” While Americans have the right to sue government officials who violate their constitutional rights, in Pierson v Ray of 1967, the Supreme Court ruled that public officials who commit “good faith” rights violations are protected by “qualified immunity,” with the purpose of preventing “frivolous lawsuits.” As specified in 2015, government employees are not able to be sued for actions taken on duty “so long as their conduct does not violate clearly established statutory or constitutional rights of which a reasonable person would have known.” While the initial intent of the ruling may have been deemed reasonable by some, the way it has been interpreted in practice has proven to be immensely problematic. The “clearly established” section of the aforementioned statement has overshadowed the latter note on “reasonable person.”

An example where this doctrine has been problematically applied is with Malaika Brooks, an African American woman who was seven months pregnant when police dragged and tasered her relentlessly in front of her eleven-year-old son. The crime? Refusing to sign a traffic ticket. The federal judges determined that Ms Brooks’ violation (driving 12 miles per hour over the speed limit) was “not serious” and she did not pose “even a potential threat” to anyone’s safety. Yet these same federal judges also dismissed the cases on the basis of qualified immunity, ruling that they did not violate “clearly established” in light of existing case law. This doctrine has significantly lowered the standard to which police officers are held to account, undermines the deterrent effects of the Fourth Amendment, and robs victims of justice.

Currently, the Supreme Court is considering whether to hear several cases where qualified immunity is relevant and many groups including the American Civil Liberties Union have been advocating for a re-evaluation of the doctrine. It is clear that change must be made. Black lives matter and it is time for our legal systems to enforce accountability for those that so flagrantly deny that.

*Note: this article focuses specifically on the US court system but similar issues apply in Canada. The New York Times has many great articles on qualified immunity as well as other legal issues that contribute to these problems. Please visit their site & other sources to learn more!

Last week, I finished working on a literature review project for my biology class. We wrote about the genetic influences that play a role in a patient’s response to antidepressant medications, and to do so, read and reviewed more than twenty major studies of depression. Most of these ticked all of the boxes to be considered ‘good’ studies. Control group, check; sufficient sample size, check; well-validated outcome measures, check, and so on. There was just one line in the Methods section of these papers that, while initially innocuous, stands out. Most of the studies only included individuals from Caucasian backgrounds.

Now, there are good scientific reasons for this, or so we are led to believe. STAR*D, a major 2006 study of depression whose participant population’s ethnic makeup resembled that of the United States at the time, noted that their inclusion of participants of many ethnic backgrounds may have limited their results. Owing to genetic variance between ethnic groups, genetic factors that influence response to an antidepressant treatment in one ethnic group may not play a role in others.

However, while this may be grounds for studying specific ethnic populations in separate studies, certainly it is not grounds for the majority of studies to be on Caucasians. And yet, this appears to be the case: a 2015 study found that Blacks and Latinos make up 30% of the U.S. population but account for just 6% of all participants in federally-funded clinical trials. Studies in related disciplines, such as psychology, report that more than 80% of participants in American psychology studies are white, despite making up only 60% of the American population.

This is problematic for two major reasons. Firstly, studying disease pathologies primarily in certain populations, i.e. participants from Caucasian backgrounds, leads to a skewed understanding of how a disease presents itself, affecting the way that it is diagnosed, and consequently, is treated. For example, skin illnesses are often misdiagnosed and mistreated in POC because they present differently from white or light-skinned individuals that are usually the examples studied in medical school. Furthermore, treatments must not only be physiologically beneficial but also economically and culturally viable. It is therefore imperative to study how appropriate therapies, interventions, medications, and other forms of treatments are in a representative population. Slight but significant genetic variation between ethnic groups suggests that it is necessary to consider disease presentation in a representative sample of the population, so that clinicians may provide accurate diagnoses and patients can receive appropriate treatment.

It is also crucial to note that POC are more likely to be affected by environmental-related ailments including asthma, cancer, diabetes, and depression. As a result of other facets of systemic racism, POC are more likely to live in poverty and have less access to education and upwards mobility, which leads to decreased access to preventative healthcare services and overall lower health outcomes. In addition, cultural barriers and stigma affect the ability of POC to access healthcare or participate in studies: Black people are supposed to be "strong", mental illness "doesn't exist" in Asian cultures, to give a few examples. STAR*D noted differences in treatment outcomes between ethnic groups: factors improving a patient’s chance of remission from depression included being Caucasian, more educated, and wealthy. Ultimately, the result is that POC are less likely to be involved in research into diseases that disproportionately affect them.

This puts the validity of evidence in research into question. Even the gold standard of clinical trials--double-blinded randomized control trials--may frequently be limited by racial bias. Considering these differences will allow us to form a more accurate portrait of disease and how best to treat it.

It is difficult for me to express the horror I feel after learning about the events that have occurred in the past month, and the despair of understanding that these are not isolated events, but rather parts of a broken system fundamentally stacked against Black and Indigenous POC. Beyond signing petitions and educating myself, I wonder what I can do--as an aspiring medical research professional--to make a difference in the field. Scientists who have written papers on this topic have simple advice for the medical research community: make research a more diverse community. Barring that, researchers need to make a concerted effort to recruit BIPOC participants into their studies. Systemic racism is pervasive into all parts of our society. Research must do its part and create a healthier, more person-of-colourful, future for us all.

Sources

Heinrich, J., Heine, S. J., and Norenzayan, A. (2010). The weirdest people in the world? Behavioural and Brain Sciences 33(2), 1-75. doi:10.1017/S0140525X0999152X.

Jacewicz, N. (2016, June 16). Why Are Health Studies So White? The Atlantic, https://www.theatlantic.com/health/archive/2016/06/why-are-health-studies-so-white/487046/.

Konkel, L. (2015). Racial and Ethnic Disparities in Research Studies: The Challenge of Creating More Diverse Cohorts. Environmental Health Perspectives 123(12), 297-302. doi:10.1289/ehp.123-A297.

“Thank God we live in Canada.”

It’s a ubiquitous phrase that seems to be nestled in all of our dinner party discussions, dining table debates, and every other conversation that, after exchanging pleasantries and commenting on the weather, eventually turns to politics.

Whenever I turn on the news, I am bombarded with information about the widening inequalities, political division, racism, and police brutality taking place in the United States. Since the 2016 Presidential elections, I have been acutely aware of the resurgence of neo-nazis and KKK members who, rather than being condemned by the leader of the free world, are referred to as “very fine people.” I’ve witnessed historically marginalized groups—women, the LGBTQ community, and Black people, along with other people of colour—being stripped of their agency and having their voices silenced. I know that these instances of oppression aren’t something that is returning after a couple of decades of hibernation, but rather, the increased access to information that the internet provides means that these problems have once again come to the forefront of our conversations. It’s just that I thought, to some extent at least, that this was a US problem and not a Canadian one.

I was only 9 years old when Trayvon Martin was brutally murdered by George Zimmerman, and 11 when Zimmerman was found “not guilty.” At the time I was too young to understand systemic racism, and how unbalanced and unjust governmental and judicial systems make verdicts like the one in Trayvon Martin’s case the unfortunate norm rather than an exception.

I was—and still am—horrified by the events taking place in the United States, of the countless news reports describing shootings that sound much too similar to Trayvon Martin’s, yet I used to think “Thank God I live in Canada” as if I resided in a place that was immune to the bigotry and oppression that I was seeing on the news. After all, we live in one of the most culturally diverse cities in the world, in a country that is supposedly praised for its tolerance and inclusivity. How could such sickening displays of discrimination be present here?

In the past few weeks, we have seen video after video showing just how deeply rooted racism is in justice systems, and while they have alerted us of all that is wrong with the United States, it’s time that as Canadians we look past these clips and into our own communities. We are a country that was created by exploiting and oppressing Indigenous communities, robbing them of their land and trying to erase their culture. We are a country, and a continent whose economy was built on the forced labour of African slaves. Despite the widely publicized stories about systemic racism and discrimination taking place in Canada, we are all still grossly uneducated. We’ve allowed ourselves to become ignorant and complacent, in turn allowing for the perpetuation of cycles of oppression to continue. Our silence has dismissed the constant struggle that Black Canadians, and all other people of colour face, in trying to obtain fair and equal opportunities in this country. Our passivity has allowed us to continue to benefit from the white supremacist structures that lift us up while simultaneously pushing marginalized groups down.

The recent deaths of George Floyd, Breonna Taylor, Amaud Arbery and too many others have brought anti-Black sentiments to the forefront of our discussions and caused us to reassess how far we have actually come since the Civil Rights Movements. The suspicious death of Regis Korchinski Pacquet has opened our eyes to the presence of police brutality in Toronto, but it shouldn’t take Black people being murdered on video by police to remind us that racism is alive and well in our communities. Centuries of transgenerational racism have permeated into every single one of our societal structures and resulted in both overt, and more casual covert forms of racism.

In reference to police brutality in Toronto, a 2017 study conducted by the Black Experience Project found that two-thirds of Black residents in the Greater Toronto Area reported being treated unfairly on a continuing basis. When study participants were asked about their personal experience with police in the community, 55 percent of Black Toronto residents and 80 percent of Black men aged 25 to 44 reported getting stopped in public places by police. 38 percent of all participants, and 64 percent of men aged 25 to 44, said they were harassed or treated rudely by the police. Nearly a quarter of men aged 25 to 44 and 11 percent of all participants said that police had used force against them. What’s more, less than half of the participants said that the police had ever helped them. The results of this study are clear: the unjust treatment of the Black community by police officers is as present in Canada as it is in the United States.

However, the anti-Black sentiments in our country go beyond our policing system. One look at our government, education systems, television and film, and the executives of Canadian companies and organizations tells us that Black Canadians, along with all other visible minorities, are severely underrepresented. In the 2019 Federal election, only 15.7 percent of MP candidates belonged to visible minorities. As of 2018 the top 25 members on Canada’s Sunshine List — the list of the highest-paid public-sector employees — was made up entirely of white Canadians.

While Canada does not have the same relationship with slavery and anti-Black sentiments as the United States, we are by no means exempt from acknowledging our history of oppression and discrimination against visible minorities. It only takes turning the pages of our history textbook back a couple of decades to remind us of the more than 150,000 Indigenous children who were forcibly removed from their homes and placed in Residential Schools, or of the eugenics sterilization movements that lasted until 1972 in Alberta and British Columbia that disproportionately targeted First Nations peoples. For anyone who claims the events of our past no longer have any impact on our future, you need not look further than the statistics highlighting the disproportionate amount of Indigenous people currently incarcerated, or the constantly growing list of missing and murdered Indigenous women to realize that racism is transgenerational, and by not owning up to our past injustices we are allowing cycles of discrimination to continue.

As more stories, studies, and videos are shown highlighting the systemic oppression and racism that pervade every facet of our society, and I continue to become educated on Canada’s anti-Black sentiments, I’m not sure if I’m really all that proud to be a Canadian. The past couple of weeks have opened my eyes to our country’s racist realities, and I know that I’m not alone in feeling helpless and angry at the fact that we’ve allowed such injustices to persist for so long. We’re stuck simultaneously wanting to do more while feeling as though no matter what action we take it will still be inadequate.

Racism in Canada is a complex and insidious problem, and the way in which we are to proceed will not become clear after a couple of weeks of protest and conversation. Our anti-Black systems have been built up and reinforced over centuries, and dismantling them cannot be achieved in a single day. Even now, I don’t really know what to do or say, or how I can make a meaningful impact to the conversations and actions taking place. But it is clear that as both individuals and a collective that we cannot move forward without first acknowledging the part we play in perpetuating racist systems. The end of our ignorance and complacency in the face of oppression is long overdue.

It’s time to stop patting ourselves on the back for “not being as bad as our neighbours to the South.” Because the reality is that there is no amount of racism allowed in our communities that is acceptable, and comparing our efforts to those of others in no way validates our own passivity. As the Black Lives Matter movement continues to unfold we must do our part, to have the tough and uncomfortable conversations about discrimination and marginalization, to educate ourselves and engage with the information we encounter. It’s time for us to call our friends and family out for their racially charged comments and interactions that used to be dismissed as a joke or chalking it up to a generational gap. We must come to terms with racism in Canada, and in doing so, reevaluate what it means to be Canadian.

Sources:

Adams, M. Wisdom, M. (2020) Yes Canada, we too have an anti-Black racism problem, The Globe and Mail, https://www.theglobeandmail.com/opinion/article-yes-canada-we-too-have-an-anti-black-racism-problem/

Billinger, M. (2014) Aboriginal and Indigenous Peoples, Eugenics Archive, https://eugenicsarchive.ca/discover/tree/535eea597095aa000000020d#:~:text=Historically%2C%20the%20Canadian%20government%20has,Columbia%20between%201928%20and%201972.

Crawley, M. McLaughlin, A. (2018) Sunshine List so white: Minorities almost invisible among Ontario’s best-paid public servants, CBC News, https://www.cbc.ca/news/canada/toronto/sunshine-list-so-white-ontario-public-sector-executives-1.4593238

Statistics Canada (2016) Immigration and Ethnocultural Diversity in Canada, Statistics Canada, https://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-010-x/99-010-x2011001-eng.cfm