A conversation with Sané Dube on the two health crises facing Black people in Canada: COVID and Racism
By early April, just a few weeks after COVID-19 was officially declared a pandemic, the headlines started appearing: Black people were experiencing an increased risk of infection, hospitalization, and death from the virus.
The stats were coming from the US and the UK, because we weren’t collecting race-based COVID data in Canada — despite awareness of the risks for Black communities, community members sounding the alarm, and supporting evidence by way of overlapping COVID and census data.
As Black Lives Matter protests erupted globally at the end of May in response to the killing of George Floyd, accelerating calls from Black community health leaders in Canada to have anti-Black racism declared a health crisis — mainstream discussions were still asking, “Is Canada racist?”
Sané Dube has been advocating for greater visibility and action with respect to the connection between race and health. Currently the Policy and Government Relations Lead, with a focus on Black health, at the Alliance for Healthier Communities, she has worked in community development, health promotion, research, and strategic policy development.
I spoke with Sané about the link between anti-Blackness and the severity of COVID among Black people in Canada, the distinctly Canadian blind spot that serves to halt progress on the issue, and what we could be doing differently to dismantle systemic racism in healthcare.
This interview has been edited for length.
Statistics are showing that Black people are more likely to die from COVID — but while the numbers are making the headlines, not everyone is gaining an understanding of why this is happening. Can we start there?
Health is about a lot more than being able to walk into a doctor’s office or being able to walk into a healthcare facility. Health is really influenced by a range of factors and the environments we live in. Social determinants of health can be understood as the conditions that you live, work, and play in — it’s really a combination of the social and economic factors that impact your health.
Housing, for example, impacts health in very significant ways in terms of stability. We know that people who are unhoused or are experiencing homelessness tend to have worse health outcomes than people who have stability and don’t have to worry about housing. These social determinants of health are really looking at health with a much broader view than just through the ability to see a doctor, nurse or healthcare provider. They’re looking at the everyday things in someone’s life that can either help their health or lead to deterioration of their health.
Early on in the pandemic, when first called upon to collect race-based data with respect to COVID, Dr. David Williams, Chief Medical Officer of Health for Ontario, responded that statistics based on race aren’t collected in Canada unless certain groups are found to have risk factors — which seems to completely ignore the existence of social determinants of health.
That moment was really shocking. At the same time that Ontario was saying we won’t collect the data, we were seeing really striking statistics coming out of the United States and also the United Kingdom. We now know that in the US, Black people are five times more likely to be hospitalized and more than twice as likely to face fatal outcomes from COVID, compared to white Americans.
We know that in Ontario it’s the same story. At the time when Dr.Williams made this comment, we were already seeing the impact of COVID on some communities. It was really disappointing to hear.
There was a lot of rallying, there was a lot of mobilization — I think people were pushing back against this thing that often happens in Canada, where we try and make invisible the way that systemic racism and structural inequality impact the most marginalized and vulnerable in our communities. We often get, ‘We’re not the same as the US,’ which invisibilizes the harm that Black, racialized and Indigenous people experience in this country.
The efforts made by advocacy groups eventually led to the Ontario government changing course on the collection of race-based data for COVID, which is certainly a win. But to put that in perspective — this can’t be the first time this conversation was happening, right?
You’re right. This is not new. People have been calling for this for literally decades. I was looking at something today — someone showed me a committee that had been put together in 1998, asking for the collection of this data. I think that this happened to be a window of opportunity because of the devastation that we have seen with COVID.
Data is collected in Ontario for other sectors. Education collects data by race. Justice also does. And there was a discussion, around 2017, to collect the data for health, but at the time the ministry said that there are lots of privacy concerns. I don’t think in calling for more data collection now, people are saying we should not be mindful of privacy. It’s also important to say that the collection of the data is not the end goal — but having the data means we have better tools to dismantle what causes harm.
This call was partly pushback saying, no, things are really awful, and this is not an issue just in the US. Even in Canada, Black people are dying, Indigenous people are dying, because of what happens with policing, because there isn’t a recognition of the ways that racism leads to death, or racism leads to us getting less services than other people, or getting care that just isn’t good enough.
You were a signatory on the joint statement calling for anti-Black racism to be declared a public health crisis. Can you share what led to its release on June 1, and what were the main goals of this joint effort?
You’ll remember that in the same week in the US, we had just seen the killing of George Floyd and Tony McDade, and we were talking about the killing of Breonna Taylor. Then in Canada, that same week, we had seen Regis Korchinski-Paquet, an Afro-Indigenous woman, fall to her death in police presence. There have been two other deaths in Ontario under similar circumstances. In New Brunswick, we had just seen Rodney Levi, an Indigenous man, killed by an RCMP officer, and Chantel Moore, who was also Indigenous, killed by police who were called in to respond to a mental health and wellness check.
All these things were happening in Canada, and our Premier was asked about systemic racism, and his response at that time was that ‘we’re not as bad as the US’ — the premier did later reverse this, but in that moment it had the effect of minimizing the violence Black and Indigenous communities were facing.
This call was partly pushback saying, no, things are really awful, and this is not an issue just in the US. Even in Canada, Black people are dying, Indigenous people are dying, because of what happens with policing, because there isn’t a recognition of the ways that racism leads to death, or racism leads to us getting less services than other people, or getting care that just isn’t good enough. Racism leads to our communities being underfunded, so that in the social sector, the health sector, our communities receive less. That ends up influencing our health.
With the declaration of anti-Black racism as a public health crisis, we were calling for it to be seen that racism was impacting people’s lives. It was a push to make things visible, and to then have the system be accountable for the ways that people are harmed. Declaring something a public health crisis shows urgency, that this is a critical issue that demands a response. It ensures health resources are designated, and there’s planning for the appropriate resources to be put in place, as well as accountability, infrastructure, and mechanisms for the system.
A lot of the mainstream media stories have focused on the mortality rate of COVID being higher for Black people. What’s not making the headlines that should be, with respect to Black communities and health? What about mental health?
When that question comes up, my first thought is always, how do you talk about this in a way that doesn’t pathologize Black people? Anti-Black racism, anti-Indigeneity has done so much harm and continues to do so much harm. White supremacy does so much harm to our people, and yet we often talk about mental health in a way that somehow again places the harms of these huge, unrelenting systems at the feet of Black people, without holding the system accountable for the distress that it causes to our people. What I would really like us to ask is, ‘What does this system do to Black people and in what way is it not accountable?’
I’ll give the example of healthcare workers who are dying in Ontario. Most have been personal support workers, many of them Black and racialized. It’s caused tremendous distress to their families, especially the circumstances under which they have died. I think that even the system has not held itself accountable for the way that it’s contributed to those deaths.
Earlier on in the pandemic, Chief Medical Officer of Health, David Williams, was asked about personal protective equipment for personal support workers. He initially did not name them as essential workers, or prioritize access to equipment for them. Then personal support workers started dying, and there’s no apology for the way that they have been treated, there is no acknowledgement of the way that the system has failed them. Instead, when you read about their death, it’s almost framed like they are responsible for what systemic and structural issues have done to them.
Is there a way we can tell these stories differently, so that they are contributing to positive change?
We need to be able to tell these stories in a way that also holds the system and these structures accountable for the harm that they do to people.
With Regis Korchinski-Paquet, for example, I think we have to ask, as a 29-year-old young woman, what other support had she received to that point? Had she been able to find care that was culturally appropriate and that understood her very specific cultural issues that she was bringing? If she hadn’t, then why isn’t there more of an effort, even as we discuss her case, to talk about funding for mental health programs that are designed by and for marginalized communities, so that people can get the care that they need?
Even with Chantel Moore, I think that there just hasn’t been as much useful conversation talking about the way that policing continues to be part of the colonial project in Canada. It again goes back to that accountability. So much of the media coverage in Canada has been focused on the question, is there systemic racism? — which is just a distraction, and it takes away from what people are going through.
And while we’re wasting time asking if there’s systemic racism, people’s lives are still being negatively impacted. People are still not getting the care that they need in Toronto’s North West to deal with a deadly pandemic. While we’re asking, ‘Is there systemic racism in prisons?’, people who are Black and Indigenous — who are also overrepresented in prison populations — are not getting all the supplies that they need to deal with COVID, even though they are at some of the highest risk because of the condition that people in prisons live under.
Has the conversation around racism and health evolved at all, as a result of the pandemic?
I think that we are having conversations right now in 2020 under COVID that we weren’t having in 2018, which is great. But it would be naive not to look at the ways that already white supremacy is mutating and working to keep the status quo in place. I think there’s a lot of words that are being put out, but I don’t know that most of them are turning into actual work.
You have written about how anti-Blackness is a health crisis that deserves more than lip-service. Is there anything that gives you hope for change in what’s happening now?
This is a question that we also see a lot in Canadian media. I think that hope is a critical part of resistance; hope is a critical part of being able to remake a world where we can live better. I think that often what happens when people are asked to be hopeful, is minimization of the very real pain that people are in and the difficulty of this moment. So I don’t usually answer that question, ‘what gives you hope?’ But what I do say is that I recognize hope is a critical part of resistance.