International Day for the Elimination of Racial Discrimination – March 21
Racism: A Threat to Women’s Health - Compiled by Susan White
Every year on March 21, the International Day for the Elimination of Racial Discrimination is observed around the world. It commemorates the 1960 Sharpeville massacre, in which 69 people were killed by police, 8 of them women, and another 130 were injured, during a protest against South African apartheid. Today, it serves to remind us that racism continues to be a threat to women’s health and well-being. In Canada we have historically liked to think of racism as a U.S. problem, but we must honestly face the truth that it continues to kill, sicken and diminish the lives of Aboriginal women and women of colour in our country every day.
Racism sickens and kills first and foremost through poverty. A legacy of systematic economic inequality and racial discrimination, on-going today, results in higher poverty rates among Aboriginal people and people of colour. Research shows clearly that poverty is the number one social determinant of women’s health. This is compounded by unequal access to health care among Aboriginal, recent immigrant and refugee women, and exacerbated by lack of awareness and training among health care providers. There is also too little research on the specific health situations and needs of Aboriginal people and people of colour.
Racism and Women’s Health in Canada
Racism is increasingly being recognized as a barrier to good health and health care services in Canada, as a recent report from the Wellesley Institute shows. Much of the work done on the impact of racism on women's health in particular examines the experiences of recent immigrant and refugee women. While all immigrants to Canada experience a decline in their health status, women, particularly those from non-European countries, report the steepest decline. Several books and articles examine this experience.
Sheryl Nestel. (2012). Colour Coded Health Care: The Impact of Race and Racism on Canadians’ Health. Wellesley Institute.
While not focused on women, this new literature review offers a survey of relevant academic and community-based research on racial disparities in the health of Canadians appearing between 1990-2010. In addition to surveying the research on mortality and morbidity by racialized groups in Canada, it surveys the evidence of bias, discrimination and stereotyping in health care delivery.
Available at the Wellesley Institute website [1].
Pollock, Grace, K. Bruce Newbold, Ginette Lafrenière and Sara Edge. (2012). Discrimination in the doctor’s office: Immigrants and refugee experiences. Critical Social Work, 13(2): 61-79.
This paper examines the role of discrimination on the part of health and social service providers and their staff through a study of immigrant and refugee perceptions of discrimination in five southern Ontario communities. While not focusing specifically on women, it does report women’s experiences.
Available at the University of Windsor website [2].
Denise L. Spitzer (Ed). (2011). Engendering Migrant Health: Canadian Perspectives. University of Toronto Press.
This collection, while not specifically focused on women, does contain several articles looking at women’s experiences and change strategies. For instance, Ilene Hyman describes “The mental health and well-being of immigrant and refugee women in Canada,” Michèlle Kérisit contributes “Examining the health of immigrant and refugee francophone women living outside Québec,” and Sara Torres et al. discuss “Empowering women through community work: Strategies within the Latin American community in Ottawa.”
For more information, see the University of Toronto Press website [3].
Vijay Agnew (Ed). (2009). Racialized Migrant Women in Canada: Essays on Health, Violence and Equity. University of Toronto Press.
Divided into three sections—relating to violence, health and equity—this collection of essays examines the experiences of immigrant women living in Canada. Specifically, the essays focus on women in several distinct communities, revealing the inequalities within the economic, legal and political systems in this country. The essays describe the situations for immigrant women living in densely populated urban centres as well as those in smaller communities and demonstrate regional disparities as they relate to the three overarching themes. Some of the diverse issues address by the essays include: the social construction of Muslim women, access to health care, earnings inequity and violence against immigrant women.
For more information, see the University of Toronto Press website [4].
Ilene Hyman. (2009). Racism as a Determinant of Immigrant Health. Public Health Agency of Canada and the Metropolis Project [5]. Also available in French: Le racism comme déterminant de la santé des immigrants [6].
This policy brief written for the Canadian federal government presents evidence of the major health and health access inequities that exist for racialized people in Canada and elsewhere, and for racism as a determinant of health, based on a review of the literature available at the time. It proposes policy and research actions to address racism and reduce health inequities.
Several recent books demonstrate the complexities of racism’s impact on women’s health and show us some ways forward. While the books below are all based on U.S. research, there are extensive parallels to Canada.
Evelyn Nakano Glenn. (2012). Forced to Care: Coercion and Caregiving in America. Harvard University Press.
Like Canada, the U.S. faces a growing crisis in care: the number of people needing care is growing while the ranks of traditional caregivers have shrunk. Glenn offers an innovative interpretation of care labour in the United States by tracing the roots of inequity along two interconnected strands: unpaid caring within the family; and slavery, indenture, and other forms of coerced labor. By bringing both into the same analytic framework, she provides a convincing explanation of the devaluation of care work and the exclusion of both unpaid and paid care workers from critical rights such as minimum wage, retirement benefits, and workers' compensation. Glenn exposes the underlying systems of control that have resulted in women—especially immigrants and women of color—performing a disproportionate share of caring labor. Finally, she examines strategies for improving the situation of unpaid family caregivers and paid home healthcare workers.
For more information, see the Harvard University Press website [7].
Dorothy Roberts. (2012). Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-First Century. New Press.
Roberts argues that a decade after the Human Genome Project proved that human beings are not naturally divided by race, the emerging fields of personalized medicine, reproductive technologies, genetic genealogy, and DNA databanks are attempting to resuscitate race as a biological category written in our genes. “Americans are accepting a genetic ideology rooted in race that makes everyone responsible for managing their own lives at the genetic level instead of eliminating the social inequalities that damage our entire society.”
For more information, see the New Press website [8].
Khiara M. Bridges. (2011). Reproducing Race: An Ethnography of Pregnancy as a Site of Racialization. University of California Press.
Reproducing Race, an ethnography of pregnancy and birth at a large New York City public hospital, explores the role of race in the medical setting. Bridges investigates how race—commonly seen as biological in the medical world—is socially constructed among women dependent on the public healthcare system for prenatal care and childbirth. She argues that race carries powerful material consequences for these women even when it is not explicitly named, showing how they are marginalized by the practices and assumptions of the clinic staff. Weaving ethnographic evidence into broader discussions of Medicaid and racial disparities in infant and maternal mortality, Bridges shines new light on the politics of healthcare for the poor, demonstrating how the medicalization of social problems reproduces racial stereotypes and governs the bodies of poor women of color.
For more information, see the University of California Press website [9].
France Winddance Twine. (2011). Outsourcing the Womb: Race, Class and Gestational Surrogacy in a Global Market. Routledge.
There has been an international ‘surrogate baby boom’ as well-off individuals and couples hire third parties to assist them to conceive a child with whom they share a genetic tie. A critical introduction to the global surrogacy market, this is a comparative analysis of the assisted reproductive technology and surrogacy industry in Egypt, Israel, India and the United States. A short guide intended as a readable, teachable "thinking frame,” the book disentangles the intersecting roles of race, religion, class inequality, religious law, and global capitalism. It questions what role the state should play in providing individuals and families with access to reproductive technologies. Chapters include: “The Industrial Womb: Pregnancy in a Capitalist Market,” “Race, Class and Surrogate Labor: Ethical Dilemmas,” “Google Babies: Race, Class & Consumption in the Procreative Supermarket,” and “Reproductive Liberty and Reproductive Justice.”
For more information, see the Routledge website [10].
Aanna Marie Vigen. (2011). Women, Ethics, and Inequality in U.S. Healthcare: “To Count among the Living.” Palgrave Macmillan.
Exploring healthcare inequalities in the U.S. by listening closely to Black and Latina women with breast cancer, this book is of special interest to those interested in ethical and theological understandings of the effects of racism on women’s health. Vigen, a professor of Christian Ethics, issues a wake-up call, and a call to solidarity and action as she contends that ethicists, healthcare providers, and scholars arrive at an adequate understanding of human dignity and personhood only when they take seriously the experiences and needs of those most vulnerable due to systemic inequalities. The book has been praised for showing how subtle or overt assumptions of white supremacy infect even the most well-intentioned care providers and bioethicists. This new edition of a 2006 book has been updated to address U.S. healthcare realities since the 2010 Obama government healthcare reform legislation.
For more information, see Palgrave Macmillan website [11].
Keith Wailoo. (2011). How Cancer Crossed the Color Line. Oxford University Press.
Examining a century of twists and turns in anti-cancer campaigns, this path-breaking study shows how American cancer awareness, prevention, treatment, and survival have been refracted through the lens of race. Drawing on film and fiction, on medical and epidemiological evidence, and on patients' accounts, Wailoo tracks cancer's transformation from a “white woman’s plague” to a fearsome threat in communities of color. He shows how theories of risk evolved with changes in women's roles and African-American and new immigrant migration trends, and with diagnostic advances, racial protest, and contemporary health activism. He argues that the "war on cancer" continues to be waged along the color line. Nancy Krieger praises the book as an “eye-opening account” of how “the answer to the question of who is at risk of cancer and why—and the epidemiologic data that underpins it—are together shaped as much if not more by the racial, class, gender and broader political ideologies and conflicts of the times as by the actual occurrence--detected or not--of cancer itself.”
For more information, see the Oxford University Press website [12]. [12]
Susan White has been the Assistant Executive Director at CWHN since 2000. Also a university lecturer in Women’s Studies, she's been a feminist community educator, researcher and activist in international development, social policy and trade union leadership for many years. Susan’s particular passions are the well-being of newcomers and refugees and anti-racism education.