Legacy of Strength, Future of Change: Angela Robertson’s Black Experiences in Health Care Symposium Keynote
The closing keynote at the 2020 Black Experiences in Health Care Symposium from Angela Robertson, Executive Director of the Parkdale Queen West Community Health Centre, offered an insightful overview of the structural challenges and systemic barriers Black people in Ontario face when accessing care and navigating social systems.
Angela began by drawing a thread between the struggles faced by Indigenous communities and Black communities. “Our sights of struggle intersect with other people’s struggle, particularly Indigenous,” she stated.
Identifying the structural issues and how displacement, dispossession, and marginalization are based on legal constructs and manufactured in deliberate and ongoing ways. She reminded attendees to work in solidarity with Indigenous peoples and be mindful of divisions between communities, as these positions erode the alliances necessary for change.
Her remarks offered a brilliant summary of the day, weaving together the ideas that resonated with her personal experiences and the actions necessary to create a more equitable and effective health care system.
Here are a few snapshots of the conversations that took place at the symposiums and the actions that Ontarians can take to work toward equity.
On data: The importance of quality data and equity was highlighted repeatedly. It is a proven and effective way to reveal disparities, inform strategies, and create action to improve health outcomes. Data that can be stratified by different identifiers and identities can be a powerful tool – for positive change, but it also comes with risk. Angela encouraged the community to be deliberate and careful with data collection and ownership and use.
On accessing care: Transforming care will require change beyond the health system. The criminal justice system, education, and economic systems will require meaningful change. The legacies of how Black people have experienced and been positioned within these systems must also be more visible. “Where Black people enter health care isn’t always through the door of the hospital,” Angela shared, referring to a patient story shared early in the day where necessary care was finally accessed through the criminal justice system.
On partnership: Angela emphasized the importance of provisional alliances – connections and partnerships that are linked to now, to promote short-term, strategic decisions. Despite personal tensions, surface-level differences, or diverging values, groups can realize mutual benefits on a single purpose, even if it’s not an eternal or all-encompassing connection.
On using the tools that exist: There are tools that have been developed and used successfully – but they’re sitting with teams and not being spread or used where they could make the biggest impact. Data collection tools used to create change in Children’s Aid and Toronto District School Board, and successful strategies that sit with Toronto Central LHIN and Sinai Health can be put to better use. Success stories like TAIBU, Women’s Health in Women’s Hands, and Black Health Alliance also shine a light on what’s possible with the right tools in the right hands. Sharing those tools across the health care system, supported by a mandate from Ontario Health for use and development with Ontario Health Teams, is a straightforward way to change the system.
On allies: Allies need to give voice to issues in order to demonstrate the widespread negative impact and help carry the burden and emotional labour of these systemic issues. “If we bring it up, we’re dismissed, told it’s not real, told we’re angry. If someone else brings it up, it carries more weight. We need strategic allies -- not to speak on our behalf, but to strategically speak.” Echoing sentiments shared by Lydia-Joi Marshall of Black Health Alliance in the closing remarks, we can’t expect those who have been marginalized to also do all the work of fixing the issues.
Directing efforts toward the same, unified and sustainable outcomes will ensure the system can be built with purpose, to support Black people and make a Black health strategy approach top of mind for decision makers and influencers across Ontario health. “The Healthy Ontario vision must include us,” she said.
Taking the knowledge and proven impact of race-based data to the decision-makers, and policy level where widespread, systemic change can be implemented was top of mind as the symposium was ending. Angela asked the leaders in the audience to share their knowledge and push those at their level or above them to act. “Influencers in this room, if not now when? The body of evidence on value of collecting disaggregated data on race, gender, income is clear to us who are present. How do we move forward to the sphere of influence?”
To close her remarks and the day, Angela illuminated the legacy and future of Black activism and systems change, calling community members and allies to continue to strive for a better health care system in Ontario.
“Good intentions aren’t going to move us forward. Liberation historically the word used. The work of liberation and writing wrongs is never done,” Angela stated. “Collecting race-based data is a tool we can use to address those sites of inequalities and wrongs. We must be relentless. We in this room, our allies and communities, must be relentless in pursuing strategies that develop better health outcomes for Black communities.”
The conversation about Black Health provided a model that offers better outcomes and benefits for all Canadian communities. Improved health outcomes and a more equitable system ensure all Canadians receive the care they need and that the system can function in the most efficient and effective way possible.