The cost of medical racism is too high to ignore

While the world’s attention is often captured by sudden public health emergencies, a quieter, more insidious crisis is tightening its grip on Black women across Canada. The recently released Voices Unheard report by the Black Women’s Institute for Health (BWIH) illuminates a reality that many in the community have long known but rarely seen quantified with national precision.

This first-of-its-kind community-driven dataset, drawing on the experiences of nearly 2,000 Black women, girls, and gender non-conforming people, reveals a pattern of medical racism that shapes how Black women are treated, how long they wait, whether they are believed, and whether they receive the care they need to live. To attribute these outcomes to individual choices would be to ignore the structural narrative of systemic inequity driving this public health emergency.

The data paints a sobering picture of the burden Black women carry. According to the report, 42.4% of Black women have delayed or avoided seeking healthcare due to concerns about how they would be treated. Nearly half of Black women are walking away from the healthcare system, knowing something is wrong, but choosing the risk of illness over the certainty of dismissal. When they do seek care, 66.7% report that their health concerns were dismissed or not taken seriously by a provider.

The consequences of this systemic neglect are profound: 27.6% of respondents reported thoughts of self-harm, a rate seven times higher than the national average. Collective care practitioner and research associate, Siobhan Stewart, emphasized this demoralizing reality, noting that constant delays and dismissals erode trust and create a dehumanizing environment. The evidence is unequivocal; access without dignity, being heard, and safety is not care.

This crisis emerges from an interplay of systemic racism, economic instability, and constrained access to culturally competent care. As Kearie Daniel, Founder of BWIH, articulated during this week’s Queen’s Park press briefing, early intervention and preventative care are foundational to health outcomes. When a significant portion of the population avoids the doctor, the system incurs greater costs, outcomes deteriorate, and people die. The report documents that 48.6% of respondents have experienced gender-based violence, while 68.5% have faced discrimination in the workplace. These social determinants of health, the economic and social conditions that shape individual and group health outcomes, intersect with race and gender to create compounding challenges that demand wholistic, systemic solutions.

The systemic drivers of these disparities are further illuminated by the absence of foundational data and equitable funding. measure oral healthcare systems continue to operate without the comprehensive race-disaggregated data necessary to identify, measure, or address health inequities affecting Black communities. The inequity is magnified for Black women, who face the compounding effects of misogynoir, the specific intersection of anti-Black racism and misogyny that shapes how Black women are perceived and treated across institutions. The recent passing of Dr. Juliet Daniels, a pioneering researcher who made breakthrough discoveries in breast cancer research identifying higher rates in Black women, serves as a poignant reminder of the vital need for targeted, well-funded research that reflects our realities.

What this moment also makes visible is the extraordinary power of Black women who, despite these barriers, continue to organize, advocate, and build solutions. The Voices Unheard report itself is a testament to that power, a community-driven act of documentation that has moved to the Legislative Assembly floors at Queens Park in a single year. The forward actionable recommendations that demand immediate political will and investment. Such as, the Government of Ontario should implement a provincial Black Women’s Health Equity Framework, complete with mandatory racial equity audits and consequences tied to funding and leadership accountability.

Along with substantial investment in Black-led, community-driven models of care, including fully covered culturally grounded mental health care and a strong pipeline of Black healthcare professionals. Complemented by the mandate of race-disaggregated data collection and the establishment of independent oversight bodies are essential to enforce accountability.

Federally, as the National Framework for Women’s Health in Canada Act evolves, the explicit inclusion of Black women should evolve with it. While at the provincial level, advocates are pressing leaders to follow the precedent of systemic action, much like the Black Health Equity Act (Bill 115) tabled by France Gélinas (NDP), Robin Lennox (NDP), Kristyn Wong-Tam (NDP), and Tom Rakocevic (NDP) to address documented systemic inequalities, often aligned with initiatives like the Black Health Plan for Ontario. As Chenai Kadungure, Executive Director of the Black Physicians’ Association of Ontario, pointed out, deep systemic change is not a zero-sum game; building a healthcare system that works equitably for Black women fundamentally improves the system for everyone.

Change requires policy, investment, and accountability. Community members can take immediate action by contacting their MPP through the BWIH Day of Action portal at voicesunheard.good.do. Black women are not waiting to be saved; they are building the movement themselves. The task before political leaders is to meet that power with the policy and investment it deserves.