Statement Against Racism and Violence

September 2020

Given the epochal protests occurring in North American society and worldwide against police violence directed toward Black men and women, as leaders and members of the University of Toronto’s Department of Medicine, we feel compelled to speak out.

Police violence and over-policing disproportionately affects Black and Indigenous people. In Toronto, a Black person is 20 times more likely to be fatally shot than someone who is White. In Canada, Indigenous women are 3 times more likely than non-Indigenous people to be victims of violence, and 38% of people who have been killed by police across Canada since 2017 were Indigenous. The Ontario Human Rights Commission recently detailed the severe consequences of racial profiling on Indigenous and racialized communities, and Canadian courts have consistently shown that racial profiling is not related to a few “bad apples” but is a systemic problem that permeates our institutions. We argue that police violence is a critical public health issue because it is foreseeable, recurring, life-threatening and preventable.

Public health is a branch of medicine focused on prevention of disease and injury. It goes beyond the individual patient and requires a focus on societal health. Confronting racism in law enforcement and the criminal justice system is essential for public health; however, it is insufficient. As members of the health care system, we must take responsibility as well. We recognize the presence of structural racism within the Canadian healthcare system and our complicity in its perpetuation. As physicians, we participate in a system that neglects public health. Canada spent more than 250 billion dollars on healthcare in 2019, 25% of which funded acute care hospitals, whereas only 5% of the annual budget was spent on public health.

In addition, systemic barriers limit access to health care resources for Black and Indigenous people. Racial profiling and discrimination within the health care system results in a reluctance for racialized people to seek care. Substandard access to healthcare services is only one component of challenges faced. Colonial policies and their downstream effects, including inadequate living conditions, food insecurity and the intergenerational trauma of the residential school system and child welfare policies, directly impact the health of Indigenous peoples. The power imbalance within doctor-patient relationships, the lack of acknowledgement of intergenerational trauma, the lack of representation within our own ranks of individuals from historically marginalized communities, and the limited understanding of intersectionality by healthcare workers critically undermines the experiences of Black and Indigenous people within the healthcare system.

We are leaders and members of the University of Toronto’s Department of Medicine; however, we cannot speak on behalf of all of our colleagues or students. Nonetheless, we feel that staying silent is not an option. Silence means condoning racism and permitting its perpetuation. We refuse to do so. We write this letter to hold ourselves accountable, as individuals and as a community.

Towards this end, we commit ourselves to the following: