Culture, race, and ethnicity
The Ontario Public Health Standards groups culture, race, and ethnicity as a social determinant of health; however, it is important to differentiate between these factors.
- Race is described as perception of race, colour, or other superficial characteristics such as skin tone or hair texture; examples of racial categories are Black, South Asian, and White.
- Ethnicity and culture are understood as ethnic, cultural ethnic, or national groups, for example, identifying as Mexican or Korean (1).
Race is a social construct. It is an idea created by humans, with no basis in biology (2). Racism and its effects go far beyond individual acts of discrimination and its most broad effects are systematic, often invisible for those who do not experience it first-hand. It is a common misconception that only Black, Indigenous, and other People of Colour are affected by racism. These groups experience the negative effects of racism; however, we are all affected by racism. For example, White North Americans often unknowingly uphold systems of racism that serve to benefit their own race.
Race impacts health through the effects of racism. To understand how race impacts health, there must be a baseline understanding of how racism works.
The three levels of racism are described as follows (3):
Institutional racism: The most dominant form, this type of racism creates differential access to the goods, services, and opportunities of society by race. Characteristics of institutional racism include initial historic insult, structural barriers, inaction in the face of need, societal norms, biological determinism, and unearned privilege.
Examples: Housing, education, and income inequalities between racialized groups, and White people.
Personally mediated racism: Prejudice and discrimination, where prejudice means differential assumptions about the abilities, motives, and intentions of others according to their race, and discrimination means differential actions towards others according to their race. This is what people typically think of when they think of racism.
Examples: Screening a job applicant out due to a Black sounding name, teacher devaluation, being followed in a store for suspected theft, disrespect from healthcare providers.
Internalized racism: Members of the stigmatized races accepting negative messages about their own abilities and intrinsic worth.
Examples: self-devaluation, helplessness, and hopelessness.
Public Health’s role
- Critically evaluate data practices to ensure they are anti-racist and decolonizing. This includes alignment with Engagement, Governance, Access and Protection (EGAP) and Ownership, Contral, Access, and Possession (OCAP).
- Increase the capacity of HPEPH’s workforce to meaningfully engage local Indigenous communities
- Developing and implementing a flexible, multi-component cultural safety training plan.
Land acknowledgement
HPEPH has developed a land acknowledgement, as a first step in our ongoing commitment to reconciliation. This Land Acknowledgement has been developed in consultation with local Indigenous communities. We will continue to revise and update the land acknowledgment as needed to reflect the current reality of Indigenous peoples in our region.
Other resources in the community
Indigenous status
The health of Indigenous Peoples is important to us. In the spirit of reconciliation, we are working with our local community partners to share meaningful content on this topic that respects “nothing about us without us”.
Public Health’s role
- Encouraging staff to participate in Indigenous Cultural Safety training.
- Organize the KAIROS Blanket Exercise undertaken by the Board of Health and select staff as a tool to learn about the history of colonialism and Indigenous People across what we now call Canada.
- Implementing an internal Indigenous Cultural Safety Capacity Building Plan
References
- Colour of Poverty Colour of Change. Disaggregated Data Survey Template. 2019.
- National Collaborating Centre for Determinants of Health. Let’s Talk: Racism and Health Equity (Rev. ed.). Antigonish, NS: National Collaborating Centre for Determinants of Health, St. Francis Xavier University. 2018.
- Jones CP. Levels of Racism: A Theoretic Framework and a Gardener’s Tale. Am J Public Health. 2000;90(8):1212–5.
