Culture, Race and Ethnicity
Culture, race and ethnicity are grouped together as social determinants of health; however, they are not all the same.
- Race is described as perceptions 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. Race 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 with 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
- Develop an Anti-Racism Strategy and make a public statement on racism and public health.
- Strive to collect race-based data in order to better identify and understand health inequities related to race.
- Educate our staff to reject racism and direct them to appropriate public health related resources.
- Provide evidence to municipal leaders and decisions makers about the unintended health equity impacts of various policies and by-laws.
Other Resources in the Community
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.
- 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.