Throughout Black History Month, there will be opportunities to celebrate Black history, culture and innovation, chances to learn about the achievements and contributions of Black Canadians to life in this country and beyond, and important lessons and history to learn. Especially during this month, but also every day, we have the chance to learn about history from the stark facts of oppression and the history of anti-Black racism here in Canada, and its ongoing impacts on Black people and communities and their health.
In Canada, it is a milestone year recognizing three decades officially marking Black History Month in February as a nation. The theme set out by the federal government this year is: “30 Years of Black History Month: Honouring Black Brilliance Across Generations — From Nation Builders to Tomorrow’s Visionaries.” Black history in Canada, and even Black History Month itself, predate the motion brought in the House of Commons in December 1995, made by the Honourable Jean Augustine, the first Black Canadian woman elected to Parliament. That motion, and the motion made in 2008 by Senator Donald Oliver, the first Black man appointed to Canada’s Senate, “to Recognize Contributions of Black Canadians and February as Black History Month” both passed unanimously. Black leaders, historians and community advocates spent decades before that bringing Black histories and stories to life, and advocating for regional Black History Months, in Ontario, Toronto and elsewhere. It is a month-long celebration and opportunity that was and is decades in the making. Black History Month is remade every year, with an eye on the past, present and future.
As we look ahead to the future, from a present that is increasingly unstable and often regressive and racist, in its attitudes, policies and system changes, we must continue to find ways to build on the solidarity and single voice used to speak out against anti-Black racism, oppression, and systemic discrimination. In health care and social services, ensuring health equity and culturally safe care is an issue of life and death, and a key path towards a more just and equitable future. At the Alliance for Healthier Communities, one of the key drivers of that path of health equity for Black people and communities in Ontario is the Black Health Committee. Made up of Alliance members working with Black health partners across Ontario and Canada, the Black Health Committee is striving to better understand the needs of Black people and communities, and the barriers they face, to innovate to serve African, Caribbean, Black communities better and in more culturally safe ways, and to measure the results and impacts.
The Alliance spoke with Dr. Akeem Stewart, Provincial Lead Black Health and Wellness, in advance of Black History Month, to get a deeper sense of the work being done right now to improve Black health and wellbeing, and where the focus of the Black Health Committee and its partners will be in the months ahead. Here are some of the highlights from our conversation:
Alliance: As Ontario is in the middle of a transformation and expansion of Primary Care teams, can you speak to the importance for Black health of focusing on the local needs of community, and tailoring Primary Care and its services and programs to be culturally safe?
Dr. Stewart: We have to understand that primary care is really important, especially when it comes to community. There is far more that goes into primary care than just seeing someone for a common cold. It is that first line of defence that educates and shows patients that changes to lifestyles can help with the preventative aspect of wellness. That is the cure to the heavy load of what is occurring at the tertiary and acute levels of health care. You have to reach communities where they’re at. It’s important to be sure that the visibility of what we’re doing is being seen through a lens that is honest and true that the community can relate with. This is also why communication is so important. The community has to be part of what we are trying to build together. We can't build something for people if we don’t have their input. The community is the heart and foundation of primary care, and their support is critical in determining how we step forward to be able to serve them better.
Alliance: Can you speak to some of the work that you and the Black Health Committee and its members and partners have undertaken so far?
Dr. Stewart: When you start to see exactly where the health disparities exist and understand the population that you’re engaging and communicating with, as well as treating, certain trends will become apparent. Whether it’s Black men’s health, Black maternal health, Black seniors’ health or otherwise, it gives you opportunities to start to create conversations when it comes to preventative care, and give people opportunities to come into places where they’re safe. It’s important to have these conversations from a space of resilience, but not from a space of lack. For example, if I need to speak to someone about prostate cancer and screening, I would speak about the importance of prostate cancer, how we can become stronger as men within the role, for our families, by making sure we get tested and not taken by a disease that is curable. But I wouldn’t speak to someone about prostate cancer and say, “Oh, I've had a family member who’s died and I wouldn't want that happen to you.” Both examples are conveying the same message, but one narrative comes from a place of fear-mongering, and the other from a place of empowerment.
That’s the principle that Ubuntu lies within. I am because you are. It’s supposed to empower you to be able to step forward and embrace that sense of togetherness that you find within community. That is the cure for a lot. Once we have community, you have unlimited access to the support it provides, and you have people around who you can have those health-related conversations with. Then you can start to really remove those myths, barriers, and taboo misconceptions from conversations about health that really and truly should be more normalized.
Alliance: Can you speak to some of the work that’s been done and is being done to address health disparities faced by Black people and communities through better, more tailored primary care?
Dr. Stewart: There is the SCAGO (Sickle Cell Awareness Group of Ontario), who are doing fantastic work on sickle cell anemia and being able to treat it at a primary care level. We are also looking at the Ontario Renal Network, where they are focusing on making sure that Black people with chronic kidney disease, who we know face significant disparities accessing care, are getting the treatment that they need. This ranges from dialysis to transplants.
You can see systemically that they’re trying to address the gaps. The concern is that there are many, and they are multi-faceted. We have a gap in knowledge and data with Black maternal health, despite the copious efforts being done to address this. There are also still major gaps with Black mental health – especially with our youth. That’s also being addressed with the great work being done by the Centre for Addiction and Mental Health (CAMH) and its AMANI program. They have built something special that is truly focused on Black youth, providing a safe space to have these conversations. However, there’s still a lot of opportunity to make it more widespread, but in the areas where they are doing it, it’s been seeing really great results so far.
Alliance: The Black Health Committee is engaged with medical students, and a program to introduce Black physicians to the Model of Health and Wellbeing that is used by Alliance members. How’s that work going?
Dr. Stewart: It’s been really good. So much so it’s been expanded, actually. We have four or five participating sites when the program first launched. As of last year we are up to eight or nine sites total. We had at least 10 students enrolled in the program last year as well. With the community health education program, we’re allowing students of Black culture to come into community health centres and see the work that’s being done to treat those of their community and learn about primary care at the level of community health. It’s important to be focused on diversity in our sector, and championing that representation of Black doctors coming through the pipeline, especially into primary care.
Alliance: What is ahead for the Black Health Committee right now, and what other message would you like to send about Black Health at the beginning of Black History Month across Ontario and Canada?
Dr. Stewart: I think the biggest thing is that we are really trying to ensure that a continued holistic effort is put forward and that we work as a collective. We want to continue to maintain the standard of transparency that is critical to what the Black Health Committee is. We’re really trying to make sure that everyone around us can look at the work being done and the partnerships being formed and say, “OK, we’re ready to get involved and invigorate and inspire.” That is what we want to do. With the work that is being discussed at all different levels, we have a special opportunity to come together and put that into action, and we want to make sure that we stay aligned with the community while we do this. The quantitative narrative is allowing us to speak in rooms where we may not be seated. That's where we want it to sit. So we can tell the story, show the trends, what works, what doesn't work – and how it is really making a difference in our communities. Sickle cell is a great example of that, how they took the model and went across many, many different areas. But it still has a lot of opportunity to grow.
We don't want to get comfortable. We want to continue to keep growing to make sure that we can serve everybody. We’re opening the door for the population – the whole population. We’re talking about 2SLGBTQ+ communities; within that, there’s a Black population. We’re talking about the Indigenous communities; within that, there’s a Black population. We’re also talking about newcomers, Francophones, people experiencing homelessness. They all have a Black population. So, this is important to understand that the health that we are focusing on is not just Black; it stretches across every single high-priority population. We’re doing this work because we’re here to provide primary care for those who’ve been strategically marginalized for over 400 years, to ensure culturally safe care for all.