Gaining a clearer understanding of the factors affecting Black health outcomes

Studies have found that Black communities experience consistently poorer health outcomes than other groups as a result of racism and associated structural inequities. Falan Bennett, a master’s student at the University of Toronto Dalla Lana School of Public Health, is examining the issue in relation to two specific health crises: COVID-19 and maternal illness and death.

“We have to shift our understanding of race to recognize that it’s a social factor, not a biological one,” says Bennett. “Being Black is not a pathology. It’s racism and colonialism that are driving the health outcomes.”

Filling the gaps in race-based data

Bennett’s research, funded by a SSHRC Canada Graduate Scholarship, aims to fill a gap in the Canadian research landscape: a lack of race-based data that would provide deeper insight into the health of Black Canadians.

In the United States, research has shown that Black women have much higher rates of maternal illness and death than women in other demographics. While anecdotal evidence suggests a similar reality in Canada, there is insufficient data to prove it, in part because most Canadian surveys and data collection mechanisms don’t ask about race.

For the first phase of her project, Bennett is analyzing U.S. data from various studies and public sources (such as census data and government records) at the county level to establish a baseline for comparison with state and national data. She’ll then turn her attention to Canadian data, including the Canadian Community Health Survey, to isolate as much race-based data as possible.

“When this research gets published, it will include some discussion about race-based data collection because I think that’s a really important conversation,” says Bennett. “Even within Black communities, there are different opinions about what data should be collected for what purposes, so whatever decisions are made, it’s critical that they be community-led.”

Hit harder by COVID-19

Bennett is also part of a transnational research project on disparities in COVID-19 outcomes for Black people around the world. Her role as a research assistant involves examining both peer-reviewed literature and less formal sources such as newspaper and magazine articles, webinars, and community events for insights on how Black communities are affected by and responding to the pandemic. Although these are not traditionally included in scoping reviews, the newness of COVID-19 means there are very few formal, peer-reviewed articles on the Black experience.

The overall research is ongoing, but Bennett’s review has already identified a number of recurring themes, including racism, colonialism, and employment- and housing-related issues.

“There are some pretty clear structural issues starting to emerge as reasons Black people are hit harder by COVID-19,” she says. “When you look at who’s working the jobs that can’t be done from home, who’s living in crowded multi-generational homes, you really start to see a pattern.”

Better policies for better health

Bennett hopes her research will be taken up by public health and healthcare policy-makers to address key issues including stigma, paternalism, misogynoir (the intersection of racism and misogyny) and other elements of racism that result in poorer health outcomes—whether from global pandemics or giving birth. New policies could, for example, improve access to the kinds of birthing services Black communities are seeking, such as doulas and midwives, which are currently not publicly funded. Making these services more broadly available and affordable could mitigate some of the health risks Black women face.

“The maternal experience shapes both mother and child for the rest of their lives,” says Bennett. “When racism manifests at that stage, it has serious, long-lasting consequences.”