Opinion: A need for standardized race-based data collection in Canadian health care
Rachel Almaw was awarded the 2022 Faculty of Health Co-op Student of the Year. She worked for three co-op terms in the Mobilize Clinical Biomechanics research lab, which is based in Waterloo’s Department of Kinesiology and Health Sciences. It was through these co-op terms that she found her calling.
Almaw focuses her research on the intersection of health and race. We asked her what needs to change in Canada’s approach to data collection and research to create a more equitable health-care system.
Rachel Almaw (BSc ’23, Master's in progress)
Alum, Faculty of Health
> 2022 Co-op Student of the Year
Opinion by Rachel Almaw
Today, 4.6 million people are living with osteoarthritis (OA) in Canada, a number that is projected to rise significantly in the coming years. In some cases, OA patients experience extreme pain that might render them immobile or unable to carry out daily life tasks.
Sadly, many Black and other racialized OA patients report a lack of trust in health-care providers. They tell stories of how their symptoms and the impact of OA on their lives are not validated by health professionals. Data from the United States suggests that although Black and other racialized people are known to have more severe disease symptoms, they are less likely to receive the gold standard treatment, causing them to live with the perpetual pain of just existing.
Unfortunately, there is no data in Canada to explore whether similar issues of systemic racism exist in this country. This lack of data, in and of itself, is a critical example of our system’s failure to adequately provide accessible, quality care for Black and other racialized patients with OA. Hence, it begs the question, “What are the real experiences of Black and other racialized OA patients in Canada?”
When I started at the University of Waterloo, I had no idea what OA was, and I had some very clear ambitions: I was going to finish my undergraduate degree, then go straight to medical school. Now, I can’t imagine a career where researching the intersection of race and health in OA from a Canadian perspective wasn’t part of it.
That’s why I kept returning one co-op term after another (for a total of three terms) to the Mobilize Clinical Biomechanics Lab, based in Waterloo’s Department of Kinesiology and Health Sciences. I’ve found my purpose is to pursue equitable health care for all, but this is not something that I can achieve alone.
The fact that Canada does not have a standardized and consistent approach to race-based data collection in the health-care system makes answering my earlier question a bit more challenging. However, I can confidently deduce that a lack of data does not mean the absence of inequalities in health-care treatment of Black and other racialized OA patients here.
I believe the solution for a more equitable health-care system in Canada can be achieved by adopting the four following approaches. Firstly, we need to create a standard for collecting race-based data. Second, we must individualize care that reflects the person and their context. Third, improved bedside approaches are needed to validate patient experience and engage patients in shared clinical decision-making. Finally, we must engage the Black and other racialized communities in the health-care system as clinicians to create a more equitable future for health care in Canada.
