the pursuit of true health equity for black women in canada
8 minute read
kearie daniel founded the black women’s institute for health out of a search to understand what was happening with mental health among black women.
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kearie daniel remembers her grade 4 teacher telling her mom that she couldn’t expect so much from her daughter. the teacher was trying to move daniel into a special education class, suggesting the program would be a better fit. daniel, however, had no learning delays or neurodivergent challenges. she was a young black girl trying to do her best.
“when i was younger navigating the education system, my mom was very much my advocate and my voice and really kind of pushed for me to be successful and get through,” says daniel, now an accomplished professional and executive director of the black women’s institute for health.
her mom had her own struggles at work as a black nurse, experiencing racism and seeing it happen in the health-care system, and shared some of what went on with the family.
“all that just stayed with me,” daniel says of her early life at jane and finch in toronto, an area with a high crime rate. “growing up and hearing those stories, they really live with you, and you hear the injustice. and so that was very present for me.”
when she had her own kids, now 13 and 15, her son started senior kindergarten already reading. she wanted to set him up for success. but in grade 2, he had a younger teacher who daniel thought would bring energy and new methods to the classroom. the teacher built a case around why she thought daniel’s son wasn’t performing in school, and the principal suggested he would benefit from occupational therapy and moving into special education.
“i remember sitting in the principal’s office with my mother because my husband couldn’t come. i was quiet, and she was talking and advocating for my seven-year-old. i felt so overwhelmed because i thought, ‘oh my god, she’s doing for her grandson, my son, what she had to do for me.’ and i thought nothing has changed.”
that was when she knew she had to take action and stand up for equality.
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sharing the experience of black women
as she explains, her lived experience resonates with black women everywhere: “you can’t divorce the realities of what it is to maneuver the world as a black woman from your everyday life. while i didn’t start out as an advocate, it’s always been part of me because it’s always been part of my experience.”
based near newmarket, ont., daniel started an organization with other black mothers in york region called parents of black children to support families. leading that advocacy group, she could see that black women were struggling, which prompted her research into data around mental health for black women in canada. she couldn’t find anything—but she did find statistics for black women in the united states from the u.s. centers for disease control and prevention that were alarming.
“in the last 20 years, suicide rates for black women in america had increased by about 72 per cent. but for black girls, that increase was 182 per cent, more than double. i sat with that for days and i couldn’t sleep,” she says, noting that u.s. data typically reflects similar patterns in canada.
she founded the black women’s institute for health out of a search to understand what was happening with mental health among black women, and it later broadened to encompass overall health equity when she recognized the need.
the institute spearheaded a national survey that marked the first time in canadian history where the voices of nearly 2,000 black women, girls and gender-diverse people shared their lived experiences across the social determinants of health, from accessing health care to navigating mental wellness, employment and education. the voices unheard report, released with the official launch of the institute in 2024, tells a story that has gone largely unnoticed.
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“i knew how important data was in terms of if you want things to shift, you need the data,” says daniel, adding that although canada has amazing researchers, academics and nonprofit leaders, there was a gap that needed to be addressed. “there was no focus specifically on black women. there was no kind of loud advocacy that people could turn to.”
the report had two parts, including the numbers (quantitative responses) and a thick book of quotes that respondents had written, revealing themes like pain management that wasn’t asked about in the survey, but was well represented in the personal anecdotes.
what struck daniel was how willing these women were to share their stories, given that black communities tend to be private.
giving black women a platform
“it’s hard to get black people to really open up and share, and especially about things that are so personal,” she says. then, a documentary team was looking for women to go on the record to share their stories, and more than 100 of the survey respondents said they would. “no one has ever asked, and they’ve never had a place to go with this information. and they want to tell their stories.”
of the key findings in the report, daniel highlights the concerning 27.4 per cent of black women have had thoughts of self-harm. “something is clearly wrong here,” she says, also pointing to the significant 42 per cent who said they delayed or avoided seeking care because of fear of how they’ll be treated.
“you can talk to any health-care practitioner, they’re going to tell you that prevention is so critical and early intervention. and almost half of us are not doing that.”
this report has fueled the need for a black women’s health equity strategy for federal and provincial governments, along with health-care institutions across the country. it highlights critical gaps and puts forward more than 70 actionable recommendations, now driving an urgent policy and legislative action plan in ontario with bill 115.
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“when we were putting together the recommendations, we were looking at what other organizations had also recommended, like black physicians of ontario. there was also an ottawa declaration on black health, and they had a list of recommendations.” daniel wants to be clear that the strategy is a community effort supported by black-led organizations, and not a siloed effort.
black women’s institute for health has started with a focus on ontario and plans to move its momentum throughout the provinces and territories in the months to come.
“for us, this is a nonpartisan issue. we want to work with any and everyone. we want all politicians to be engaged in this, which is why we sent [the report] to everyone.”
she also points to another reveal from the survey: two-thirds or 66.7 per cent of black women feel that their health concerns were dismissed or not taken seriously by a health-care provider. while women generally across the board feel dismissed by health-care providers, two-thirds of black women who feel this way contribute to the 42 per cent who are not going to reach out for professional help, deciding to deal with it on their own.
one of the recommendations that is part of bill 115 is the infrastructure to support the collection of race-based health data. daniel says if we can measure black women going to the doctor with pain, for example, and not being treated for pain, we can track that in the system according to race. that allows for tracking and targeting, aiming to stop it from happening with initiatives like education with physicians on culturally aware questions and approaches.
the report calls for accountability measures, where race-based care is measured with the same significance as er wait times or criteria for hospitals to maintain their accreditation.
race-based health data to identify pain points
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“if we can treat black women for what they need to be treated for, it means that they’re not coming back with more complicated, more complex issues later on, costing the system more money, right? there is an argument to be made that all of these interventions that we’re trying to put in place can actually save the system money because it makes you take a more focused look at where the pain points are and where the issues are within the system.”
she gives her own experience with mental health issues as an example. she has a great family doctor, but in 2020, at the height of the unrest following the george floyd murder in minneapolis and protests against police brutality, daniel was struggling with her mental health. she tried to express this to her doctor that she couldn’t handle things and needed a break from her work. but her doctor didn’t respond with a diagnosis or helpful strategies like counselling or medication.
“i couldn’t fully articulate what i was feeling. and as i know now, as a black woman, depression and anxiety and mental health challenges often look different. so, for black women, when the physician’s asking you, ‘well, are you having trouble focusing? are you having trouble getting out of bed?’ we’re not in bed with the sheets over us. we’re high functioning, we look put together, it’s not the same [as depression may look for caucasians].”
as a result, daniel quit her job, which was a financial cost for her family.
“in that moment, my doctor failed me because she didn’t understand. and i did not have the capacity to explain it fully to her. so imagine we have modules or we have a core competency for physicians where they have to have that kind of cultural understanding for patients to ask different questions.”
if the system shifts, these changes improve practice and outcomes for everyone, she says. “we are a black community that is advocating for this because we are harmed by the system currently. but if these changes come through and we’re able to shift the system, everybody benefits.”
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she also talks about the public misperception of systems as neutral, already positioned to treat everyone in the same way.
“systems are made up of people and there is no neutrality in systems. i think it’s a great thing that we have a government that has recognized that there is inequity,” she says, hopeful about the response to the report and tabled legislation.
“i also think whenever we post something on tiktok, for example, and i just shared about the report, i get responses from women who tell their story, and some of them will say, ‘i’m leaving the country for treatment. i don’t even bother staying in the country.’ and that makes me sad, but i’m hopeful because i think more people are seeing what the issue is—and that it’s a unifying issue that everybody and every politician can get behind.”
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