STORIES FROM THE GAP b best health OCTOBER NOVEMBER | “WHEN YOU HAVE NEGATIVE RACIST EXPERIENCES FROM HEALTH-CARE PROVIDERS AT A YOUNG AGE, YOU STOP ENGAGING WITHTHEHEALTHCARE SYSTEM.” Early experiences with racism Research from Women’s Health in Women’s Hands found that about 60 percent of young Black Canadian women experience racism in the health-care system between the ages of 16 and 21. These experiences can have a long-lasting effect, Massaquoi says. “When you have negative racist experiences from health-care providers at a young age, you stop engaging with the health-care system to avoid those types of experiences. What we end up seeing on the other side is Black women not accessing health care until things are at crisis levels.” The result, Massaquoi explains, is that Black women are often late to seek care, particularly when it comes to chronic illnesses. That means late diagnoses and treatment for conditions such as diabetes, most cancers (such as breast and cervical cancer) and mental health disorders. The lack of tangible, large-scale data only makes this issue worse; having more data might lead to actionable change. “It’s not just [about] research. It’s the consistent collection of race-based data at the point of entry into the health-care system,” she says. Many of these issues begin well before the point of care, Massaquoi adds. The impact of systematic racism has resulted in poverty rates for Black people that exceed those in the general population, which exposes Black people to chronic illness at a greater rate. And preventive healthcare measures can be difficult when a person is living close to the poverty line, Massaquoi explains. “So yes, all these things are a perfect storm that creates a scenario where Black women bear the brunt of racism when it comes to health,” she says. The way forward An important key to breaking this cycle is having more Black representation in the health-care field — and there’s some good news on that front. “[There’s] definitely an upward trend of more Black students being funnelled into medical programs within the health-care field, so in five to 10 years, when they’re done, we’ll see an increase of Black providers,” says Jacques. For their part, Jacques and her team at Wombcare are developing a research project focused on the experiences Black people have with endometriosis and fibroids. She’s hoping to collaborate with hospitals and universities, because this type of data collection is crucial to figuring out concrete interventions. Besides arising from government policies and legislation, solutions can also come from the advocacy and non-clinical spaces within health care, Massaquoi says. Currently, there are only a handful of community health centres dedicated to servicing the needs of Black women in all of North America. Grassroots organizations can focus on developing culturally appropriate solutions and programs that best cater to the health needs of Black Canadian women. “We need to create more health organizations that focus specifically on improving health outcomes for Black communities,” she says.