Health care researchers must ask, ‘Who is black?’ Professor at the University of Ottawa says

Jude Mary Cénat suggests asking research subjects a basic question: What is your skin color? From there, it can lead to unraveling other questions about origins and ancestry.

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The inability to find a common term to describe black people in Canadian health research may perpetuate inequalities, says a University of Ottawa professor.

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We need precise, precise language because research informs public health policy, health worker training, and culturally appropriate and anti-racist health care practices, says Dr. Jude Mary Cénat, associate professor of psychology and Director of the Interdisciplinary Center at the University of Ottawa. for Black Health, Canada’s first academic research center dedicated to studying the biological, social and cultural determinants of health in Black communities.

In Canadian health care research, the definition of “who is black” can vary widely. Terms like “African Canadian,” “Caribbean” and “African” are inconsistent and make it difficult to compare studies, he says.

The terms can include people who do not identify as black, such as those from North Africa and people from Caribbean countries, such as Cuba, the Dominican Republic, and Puerto Rico, who consider themselves Latin American.

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From a health research point of view, that can be a problem, says Cénat. One example: A 2019 review of breast and cervical cancer among “Black Canadian” women included 23 studies, but only seven had unambiguous black participants. Some studies considered “Africa” ​​as a single bloc and included participants from North Africa, who may identify as Arab.

“Most people in Africa are black. But you cannot assume that they are black,” says Cénat. “You can’t say that Elon Musk (born in South Africa) is black.”

Meanwhile, studies rarely differentiate between blacks whose ancestors have lived in Canada for centuries and those who are recent immigrants, he says. The 2016 census found that the 10th most commonly listed country of origin for people in Canada who identify themselves as Black was the United States.

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Getting a more accurate answer can be as simple as asking people “What is the color of your skin?” says Cénat, whose comment was published this week in the Canadian Medical Association Journal.

Investigators have multiple questions to ask, but the first is how the subject is identified, he says.

Cénat suggests asking research subjects the basic question: What is your skin color? From there, it can lead to unraveling other questions about origins and ancestry. It is also important to give research participants the opportunity to give more than one answer so that multiracial people can self-identify.

Asking questions related to race, ethnicity, and region of origin can make some people uncomfortable. “We avoided that question. We ask people about their origin, not about the color of their skin,” says Cénat.

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But health researchers can frame their questions by explaining why the questions are being asked and saying that the answers can help improve health care for black people in Canada.

“Researchers don’t have to be afraid of it,” he says.

If research on black health continues to be based on unclear or inaccurate data, there is a risk that policies and programs will not meet the real needs of black communities, Cénat warns.

Asking the right questions can also lead to more nuanced answers. For example, while the prevalence of diabetes is higher in black communities than in the general population, some black communities in Canada may be at higher or lower risk than others.

Cénat notes that in Ottawa, racial minorities make up more than 30 percent of the population.

“We need this because our population is a diverse population. We need to know more about risk factors and protective factors,” says Cénat, who studies the role that cultural factors play in vulnerability, trauma and resilience.

“We need to work with racial data that is accurate. We need to say 10, 20, 30 years in the future that we have done something for these communities.”

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