This post was co-authored by Suliana Beraki and Robert T. Muller, Ph.D.<\/p>\n
My sister’s experience of terminal illness was shaped by many factors: pain, communication, disregard, fear<\/a>, and advocacy. These often overshadowed the person at the center of it all\u2014her. The urgency to advocate for better end-of-life care consumed what little time we had left together. It was a painful reminder that care is sometimes determined by race rather than illness.<\/p>\n Michelle Regnier, a registered social worker and cancer survivor working with the Wellspring Cancer Support Foundation, comments, \u201cSome people want to make peace before passing. But too often, people and their families are forced into advocacy just to be heard.\u201d<\/p>\n Canada\u2019s reputation is that of a nation that promotes equality for all, but this ideal doesn\u2019t hold true, particularly for Black and Indigenous people of colour (BIPOC). BIPOC are both hyper-visible and invisible in the face of systemic barriers. This means being surveilled, policed, or punished to a greater extent than non-BIPOC people, but also receiving less support <\/a>from public services. This is a systemic double bind imposed on racialized people in Canada.<\/p>\n Bianca Beauchemin, an assistant professor in the School of Gender<\/a>, Sexuality<\/a>, and Women\u2019s Studies at York University, shared her insights. \u201cBlackness in Canada is often framed as a product of multiculturalism, yet it is not truly recognized. One dimension of this erasure is silence; we simply do not talk about it. While racism in Canada may not always appear as overt or extreme as in other nations, it still exists in insidious and systemic ways.\u201d <\/p>\n Systems of social infrastructure are all still embedded with structural racism.<\/a> These acts of racism may not always be conscious, but their impact is nonetheless felt. The pain of BIPOC communities is frequently dismissed. For many, the promise of care is replaced by feelings of abandonment, anger<\/a>, and grief<\/a>. Their realities, needs, emotions, and agency are often suppressed.<\/p>\n Many BIPOC individuals do not trust the health care system because they have been continuously let down by it. Black and Indigenous patients experience unique forms of medical racism rooted in separate <\/a>histories and realities, which have included being subject to unethical medical experiments. Generations of mistreatment intersect with medical myths, especially for Black women, who have historically been portrayed as having higher pain thresholds<\/a>, a false belief based on biased and outdated medical research.<\/p>\n Studies indicate<\/a> that minority groups, including Black patients, experience longer wait times in emergency departments. 91 percent of studies found that Black and other racialized patients wait significantly longer for assessment than white patients, even after considering factors such as hospital location and insurance status, suggesting systemic issues beyond facility differences. <\/p>\n A 2023 U.S. study<\/a> shows Black and Indigenous women experience unfair racial treatment, especially if they have chronic pain<\/a> conditions or depression<\/a>. They also had higher odds of delaying care or using the emergency department as their usual source of care rather than booking a doctor\u2019s appointment.<\/p>\n In Canada, as recently as 2024, over one-quarter<\/a> of Indigenous people waited two weeks or longer for non-urgent care. One in five reports unfair treatment and racial discrimination<\/a> from health care professionals.<\/p>\n Regnier explains the challenges of advocacy amid ailing health, \u201cThey have to say things like \u2018I should be treated with dignity\u2019 or \u2018I matter.\u2019 The system becomes central to their experience when it shouldn\u2019t be. That\u2019s not fair. That\u2019s not a collaborative, supportive, or empathetic<\/a> process\u2014and it should be.\u201d<\/p>\n The neglect from the system and the subsequent mistrust<\/a> can lead to chronic stress<\/a> and trauma<\/a>, which contribute to poor health outcomes<\/a>. Racial trauma can also intensify<\/a> the grieving process for BIPOC families. <\/p>\n