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Understanding the connection between racism and health
Shining a light and encouraging dialogue among health professionals, the academic community and the public about a serious issue such as racism and health in a way that is respectful, engaging and compelling is no easy feat. Yet, Dr. David Williams, a world renowned expert in racism and health, did just that.

A researcher from Harvard University, Dr. Williams visited Halifax in February 2014 as part of a visiting scholar lecture series, a collabdavidwilliamsorative effort of Cancer Care Nova Scotia, the Health Association of African Canadians, Dalhousie University and Capital Health. During the two-day visit he met with health professionals, government officials, and the academic community. He also presented a public lecture. The health professional sessions and the public lecture were made available across the province through Telehealth and live streaming.

“There was record attendance at all of his presentations and he did not disappoint, said Meg McCallum, Provincial Manager, Education and Patient Navigation, Cancer Care Nova Scotia. “His presentations emphasized that racism can have a profound effect on people’s health.”

Dr. Williams indicated that racial attitudes are complicated and are based on negative stereotypes which drive behavior. “The first things we notice about people are their age, sex and race,” he said. “Everyone has negative stereotypes which drive behavior and result in unconscious discrimination. Our actions are automatic without intent to hurt anyone or the awareness that we are doing so.”

Dr. Williams said the first step in addressing unconscious discrimination on a personal level is recognizing that you could do it. “Unconscious discrimination is a normal human process,” he said. Everyone does it and there are negative beliefs attached to certain categories. Before we are able to change this, we need to accept that ‘this could be me.’”

In 1997, Dr. Williams developed an Everyday Discrimination Survey to measure an individual’s perception of discrimination in their day-to-day life because of their race, sex, age, weight, etc. It also asked about perception of discrimination in their experiences with health care system. He found that small, ongoing negative experiences of discrimination or worry about being discriminated against wear away at a person like a constant water drop on concrete and these experiences and worries impact a person’s health.

According to a 2009 review of 115 PubMed studies published between 2005 and 2007, perceived discrimination is associated with elevated risk for diabetes, substance use, breast cancer, uterine fibroids, delays in seeking treatment, lower adherence to treatment regimes, lower rates of attending follow-up care appointments among others.

Discrimination, like other stressors, can affect health through both actual exposure and the threat of exposure,” said Dr. Williams.

Addressing the very real issue of racism and health will require the will of many. Dr. Williams says everyone can begin by reminding themselves to focus on each person as individual rather than placing them in categories. Individuation instead of categorization is how Dr. Williams describes it.

“That’s a start and each and every person has an important contribution to make,” said Dr. Williams. “But, this is not enough. It will take political will across all parties and the involvement of governments in all departments including education, housing, transportation, environment as well as communities (working together) to bring resources together in a concerted focus to modify where and how we live, learn, work and play.”

To view Dr. Williams presentation slides, visit  

Funding for Dr. Williams visit was provided by Diversity and Social Inclusion, Primary Health, Department of Health and Wellness and Cancer Care Nova Scotia.


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