Last month, the Canadian Medical Association Journal (CMAJ) published a commentary piece titled “Time to dismantle systemic anti-Black racism in medicine in Canada.” It’s part of a broader push by the Canadian Medical Association (CMA) to create more equitable spaces in line with a diversity and equity policy rolled out in March 2020.

Now a new analysis by CMAJ has dropped, with a focus on improving gender and racial inclusion. Its main argument is that gender and racial diversity in medicine improves “high-quality care” and can “promote creative solutions to complex health problems.”

“[T]here is no excuse for not working to change the climate and environment of the medical profession so that it is welcoming of diversity,” writes lead author Dr. Andrea Tricco.

“The medical profession should be professional, be collegial, show mutual respect, and facilitate the full potential and contribution of all genders, races, ethnicities, religions, and nationalities for the benefit of patient care.”

And while it should be that way, we don’t think we’re putting words into Dr. Tricco’s mouth when we say this isn’t always the way things are, and we have receipts to prove it. The new CMAJ piece makes some recommendations, and we’ll get into those in a minute but first …

RECEIPT TIME – EXAMPLES OF DISCRIMINATION IN HEALTH

As early as April, it became clear more Black Americans were dying of COVID-19, even in predominantly white areas.

In May, the Navajo Nation, which covers parts of Arizona, New Mexico, and Utah, had surpassed New York and New Jersey for the highest per-capita COVID-19 cases in the U.S.

COVID-19 has also put trans and non-binary individuals at risk, highlighting pre-existing healthcare disparities experienced by members of LGBTQ+ communities.

Social isolation, the postponement of gender-affirming interventions due to the pandemic, and a higher risk of unemployment for trans and sexual minority individuals can take a mental and physical toll.

In Canada, a December report by a consortium of B.C. health organizations revealed several horrifying instances of racism towards Indigenous patients, prompting officials to make 24 recommendations on how to improve health care for Indigenous patients.

Several studies have linked racism and discrimination to negative health outcomes, including chronic inflammation and hypertension. Being a victim of discrimination is also psychologically damaging, which can lead to depression and negatively impact sleep.

GENDER DISCRIMINATION

On the gender side, let’s talk about how Black women are more likely to suffer from pregnancy complications. According to The National Partnership for Women and Families, they are three times more likely to have fibroids that can lead to post-partum hemorrhaging when compared to white women. 

And a 2019 survey by TODAY found that more than one-half of U.S. women of all races cite gender discrimination as a “serious problem” for patients, compared to one-third of men.

About 20 per cent of the women who participated in the survey said they felt dismissed or ignored by a health provider, compared to 14 per cent of the male participants.

RECOMMENDATIONS

CMAJ suggests addressing gender inequities by targeting the medical system alongside individual behaviours.

Solutions include, per CMAJ:

  • Ensuring core principles of equity, diversity, inclusion, mutual respect, collegiality and professionalism are embedded in all policies and all stages of medicine
  • Communicating gender statistics
  • Getting buy-in from professional organizations at the national, provincial and local levels
  • Championing structural and behavioural change from the top
  • Role modelling
  • Diverse search committees for hiring
  • Flexible schedules, non-gendered parental leave and family-friendly policies
  • Career support and peer mentoring

Read more here.