Anti-Black racism is real, widespread and affects the lives of Black people in Canada. It is a daily reality that co-occurs and affects all other health conditions that Black people experience. (1,2) It is imperative that the realities of anti-Black racism be deliberately engaged within health responses and disease management. The decision to embrace and integrate Critical Race Theory necessitates review, reflection and becoming engaged in its logics and objectives. Thus, adopting and applying Critical Race Theory in medical education and clinical settings includes assessing how (not if) systemic anti-Black racism is functioning, and then taking that into consideration in the clinical setting and in the creation of an effective care plan.
The foundational structures of colonial legacies--namely, the attempt to erase and eradicate Indigenous Peoples across Turtle Island from their territories and the land, and the enslavement of African people and people of African descent--have lingering and harmful effects. In her book Lose Your Mother: A Journey Along the Atlantic Slave Route, Saidiya Hartman posits that the afterlife of slavery is witnessed through the "skewed life chances, limited access to health and education, premature death, incarceration, and impoverishment." (3) The afterlife of slavery affects all Black people in Canada, whether slavery was in their family history or they are recent arrivants. Public health and health care practices are implicated in these outcomes of the afterlife of slavery. In other words, anti-Black racism, from the time of slavery until today, continues to be an active social condition of health and wellness.
Why Critical Race Theory?
Rather than assuming one perspective or approach, Critical Race Theory advances understanding of the meaning and importance of racism and its creation of "race." (4) A collection of theoretical positions and disciplines that self-consciously views the construct of race through a critical lens, Critical Race Theory directly confronts the systemic and structural impacts of white supremacy within the lived experiences of racialized people; it poses new questions on the persistence, if not the intensification, of expressions of racism, and of discourses about and beliefs in "race." In this way, Critical Race Theory acts as a bridge between the social and health sciences to facilitate more comprehensive consciousness-raising and different interventions for Black people that would lead to improved health outcomes. (5,6)
A key element of Critical Race Theory is the understanding that anti-Black racism is not an aberration. Anti-Black racism structures how society functions. This is often the most difficult concept to grasp; to understand that racism--in particular, anti-Black racism--is present in every sector of life. Anti-Black racism today is a continuation of the anti-Black racism that fueled the trans-Atlantic slave trade; descendants of enslaved African people, brought with the colonialists who travelled to Turtle Island, still live in Canada. Indeed, the enslavement of African people was still underway in 1824, when the first medical school in Canada opened.
Colonialism, the trans-Atlantic slave trade, and the regulations of medical practices and interventions are all interwoven. Health care is not race-neutral, nor unbiased, and the rhetoric...