Health is Wealth: Health Disparities Faced by Black Canadians

Though Canada is considered one of the healthiest countries to live in, major health disparities exist throughout the country. According to the Centers for Disease Control and Prevention (2015), health disparities are preventable differences experienced by socially disadvantaged populations in the occurrence of disease, injury, violence and access to opportunities for achieving optimal health. Individual, relationship, community and societal environments all consist of factors that influence the health of a population or individual. These four environments also come together to make up the four levels of the social ecological model by the Centers for Disease Control and Prevention (2015). This social ecological model presents health as the interaction between these four environments, and will be used in this blog post to explain the health disparities faced by Black Canadians.

Figure 1.

The Social-Ecological Model: A Framework for Prevention

Note. A four-level model of the factors affecting health, by Centers for Disease Control and Prevention, 2015.

The first level of the social ecological model is the individual level. This level not only encompasses individual biology but also other personal characteristics like age, income and education (Centers for Disease Control and Prevention, 2015). Factors like education and income both go hand-in-hand in the attainment of optimal health. Education in itself is essential for developing critical thinking skills, growing confidence and identifying personal beliefs and values. Acquiring knowledge through education contributes to the development of healthy habits, informed decision making and improved accessibility to health resources and services. Shankar et al. (2013), states that individuals who receive higher education tend to have better health-related behaviours as they are more likely to have a greater sense of personal control, social standing and social support. Unfortunately, in Canada Black students still experience instances of discrimination and racism on a daily basis. These instances manifest in the delivery of harsher punishments, lack of educational resources and the disregard for academic potential by their peers and educators (Cameron and Jefferies, 2021).

Cameron and Jefferies (2021) further state that the resulting psychological trauma from these experiences can cause premature disengagement from school. When Black students are unable to complete their schooling or are discouraged from receiving higher education, this not only impacts their scope of knowledge on health but prevents them from securing future employment. In a recent presentation by the City of Toronto’s Confronting Anti-Black Racism Advisory Committee (2022), the unemployment rate for Black youth in Toronto and Ontario is stated to be two times higher than the national average. In most cases, employment is required in order to establish a source of income. As a disproportionate amount of Black Canadians are unable to secure a source of income, there is also the possibility that a disproportionate amount are also suffering with chronic disease, trauma, lack of resources and opportunities to achieve optimal health.

The second level of the social ecological model is the relationship level. According to the Centers for Disease Control and Prevention (2015) this level explores the influence a person’s social circle has on their behaviours and experiences. An individual’s social circle can include peers, friends, partners, family members and any other people they share close relationships with (2015). Umberson and Montez (2010), state that the quality and quantity of an individual’s social relationships can have a cumulative impact on their health and mortality risk. Social ties and social support may enhance personal control, reduce the impact of stress, and create norms that influence healthy habits. On the other hand, they can also lead to the development of risky health behaviours, morbidity, and premature mortality. Therefore, the presence of social ties and social support can be either advantageous or disadvantageous to the health of an individual or population (2010). The experience of discrimination and racism negatively impacts the quality and quantity of the social relationships of Black Canadians. This social variation in relationships puts Black Canadians at a disadvantage as they do not have an equal opportunity to develop a sense of personal control, experience reduced stress and create better health-related behaviours. This in turn moves them further away from the attainment of optimal health.

The third level of the social ecological model is the community level. This level looks at environments such as schools, workplaces and neighbourhoods and identifies the environmental characteristics that influence health (Centers for Disease Control and Prevention, 2015). As discussed in the first level of the social ecological model, Black Canadians face a disproportionate amount of discrimination and racism in the school and workplace. Black students are more likely to be streamed into non-academic programs, receive harsher punishments and face negative stereotypes from their peers and educators (Cameron and Jefferies, 2021). According to the Government of Canada (2020) Black Canadians also face discrimination in the hiring process, lack of recognition in the workplace, and job instability. Premature disengagement from education limits employment opportunities and impacts the ability to bring in a stable and substantial income. Due to the disparities across these environments, 24% of Black Canadians qualify as low-income in comparison to the 14.4% of the general racialized population in Ontario (Black Health Alliance, n.d.). These community factors contribute to the inaccessibility to health resources, increased stress and the development of risky health behaviours like heavy drinking, smoking and drug use.

The fourth level of the social ecological model is the societal level. The societal level explores factors like social norms and institutional policies that create or maintain inequalities between groups in society (Centers for Disease Control and Prevention, 2015). The history of European colonization and the transatlantic slave trade is tied to the deep-seated discrimination against Black Canadians seen in Canadian institutions, policies and practices (Government of Canada, 2020). These policies and practices continue to maintain health disparities by perpetuating the conditions necessary to reduce access to physical and social resources needed to achieve optimal health. Without a change made on the societal level, even with improvements made in the individual, relationship and community environments, the health disparities experienced by Black Canadians will continue to persist.

To address health disparities prevention strategies must be implemented across all levels of the social ecological model (Centers for Disease Control and Prevention, 2022). Using focus recommendations provided by the Centers for Disease Control and Prevention (2022), the following prevention strategies can be used at each level: At the individual level, programs focused on peer communication, conflict resolution, and behavioural learning can be implemented to promote positive attitudes, beliefs and behaviours that favour health. The implementation of programs focused on strengthening communication within social relationships can improve problem solving and promote positive peer norms that steer away from discrimination and racism. These strategies would be beneficial at the relationship level. At the community level, it is necessary to create safe, inclusive, and diverse environments while also addressing conditions that are not conducive to healthy environments. As all levels are interconnected, is it vital that at the societal level the Ontario government also implements preventative strategies. These strategies can include investing more time and money in educational programs for Black and other racialized youth, improving financial security in low-income households, creating employment opportunities for immigrants, and increasing access to healthcare services in underserved communities (2022). By taking into account all the above factors and considerations, a positive change can be made in reducing the health disparities experienced by Black Canadians.

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