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Report finds systemic racism in B.C.'s health care system, but no evidence of alcohol 'game'

Health Minister Adrian Dix has apologized for systemic anti-Indigenous racism in health care after a report found hundreds of examples of racism, prejudice and profiling, which result in poorer health outcomes for First Nations and Métis people.
Mary Ellen Turpel-Lafond
Mary Ellen Turpel-Lafond discusses the findings of a report on racism in B.C.'s health care system on Monday, Nov. 30, 2020. YOUTUBE

Health Minister Adrian Dix has apologized for systemic anti-Indigenous racism in health care after a report found hundreds of examples of racism, prejudice and profiling, which result in poorer health outcomes for First Nations and Métis people.

“Indigenous people and health-care workers have spoken clearly — racism is an ugly and undeniable problem in B.C. health care that must be urgently addressed,” said Mary-Ellen Turpel-Lafond, B.C.’s former child and youth watchdog and a retired judge, who authored the report released Monday. “Many of the accounts we heard were deeply disturbing, had clearly caused significant harm, and created lasting mistrust and fear of the health-care system.”

Dix apologized to all Indigenous people who have experienced medical racism, acting on one of the report’s 24 recommendations.

“I want to make an unequivocal apology as the minister of health to those who have experienced racism in accessing health care services in British Columbia now and in the past,” Dix said during a press conference. He said his apology was an acknowledgement of the pain Indigenous people have borne from racism.

Turpel-Lafond was asked in June to investigate allegations that health-care professionals played a “game” to guess Indigenous patients’ blood alcohol levels. The investigation found no evidence to substantiate the allegations. Turpel-Lafond said she found anecdotal reports that resemble the game allegations but she said “none could be described as prevalent, widespread or targeting only Indigenous patients.”

She said medical professionals sometimes estimate a patient’s blood alcohol level, which is routine and clinically appropriate, and her review did not find that Indigenous patients were profiled based on stereotypes about addictions.

The investigation interviewed 150 people and surveyed 2,780 Indigenous people and 5,440 health workers. It reviewed 600 submissions to a tip line and email address.

The survey found 84 per cent of Indigenous respondents reported discrimination in health care, with Indigenous women and girls disproportionately affected. Among Indigenous health-care workers, 52 per cent reported experiencing racial prejudice at work, largely through discriminatory comments by ­colleagues.

More than one-third of non-Indigenous health-care workers witnessed discrimination directed at Indigenous patients, and 13 per cent of 531 health-care workers made racist comments while responding to the survey.

One elder described feeling the “angry hands” of health-care workers over her lifetime. Another person said: “I am afraid to go to any hospital. When I do have to, I dress up like I’m going to church [in order to receive proper treatment]. It’s ridiculous.”

And another said: “I avoid the hospital at all costs because as an Indigenous person I feel unsafe and feel like they won’t bother treating me.”

Existing anti-Indigenous racism has been magnified by the COVID-19 pandemic and the opioid crisis, Turpel-Lafond said.

In June, CBC News said the alleged game was played at Saanich Peninsula Hospital. Turpel-Lafond said she can’t break down incidents by hospital, but First Nations leaders on W̱SÁNEĆ territory have reported significant change “in terms of the quality of service and the relationship building” at the Peninsula hospital.

Systemic racism in the health-care system includes abusive interactions, denial of service, inappropriate pain management, people being ignored or shunned, medical mistakes or disdain for cultural healing, the report says.

This causes Indigenous people to mistrust and avoid the health-care system, resulting in poor health outcomes such as high rates of suicide, stress, reduced life expectancy, increased rates of chronic disease and higher infant mortality.

Turpel-Lafond found that racism persists because employees are not willing to speak up and there’s a lack of accountability by leadership to stop discriminatory behaviour.

The report, In Plain Sight: Addressing Indigenous-specific racism and discrimination in B.C. health care, says the province should establish three leadership positions: An Indigenous health officer, an Indigenous health representative and advocate, and an associate deputy minister of Indigenous health.

Dix said the ministry will add five Indigenous liaison positions in each health authority. Dawn Thomas, Island Health’s vice-president of Indigenous health and diversity, equity and inclusion, has been promoted to acting deputy health minister and will oversee a task force to implement system-wide reform.

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