Health & Biomedical Sciences Faculty Publications and Presentations
Document Type
Article
Publication Date
11-2025
Abstract
Background: In Canadian healthcare, systemic racism subverts commitment to universal coverage by building inequities into the system of governance, regulation, and clinical practice. Although racial disparities have been documented, little attention has been paid to how institutional structures perpetuate these inequities.
Objective: This study critically examines the organizational aspects of racism in the Canadian healthcare system. It aims to identify structural obstacles faced by racialized patients and foreign-trained physicians and to provide policy recommendations grounded in evidence.
Methods: The authors employed a narrative review framework for qualitative analysis of documents. Public inquiries (eg, Truth and Reconciliation Commission and Viens Report), government audits (eg, PHAC and CHRC), case files (eg, Brian Sinclair, Joyce Echaquan, and Dr. Akinbiyi), and peer-reviewed publications between 2000 and 2024 were the data sources. Thematic coding occurs across 4 areas: (1) institutional discrimination, (2) licensing and workforce exclusion, (3) patient and cultural safety, and (4) accountability gaps.
Results: The review found continuing institutional disregard for Indigenous and Black patients, and the disparities were most marked in emergency and maternal services. Internationally educated doctors face opaque and delayed credentialing procedures, which can exacerbate workforce disparities. Case examples illustrate how system failures, including disregarding patient suffering, ignoring cultural requirements, and inadequate oversight, can lead to harm. It is a recurring pattern in which the recommended action is not taken following a review, suggesting organizational resistance to change.
Discussion: Canadian systemic racism in health care occurs through omissions (failure to act on reform) and commissions (institutional exclusion). To tackle this, it is necessary to entrench antiracism in legislation, make cultural safety training a requirement, collect race-disaggregated data, and transform licensing routes.
Conclusion: Universal healthcare is not equitable unless systemic racism is eliminated. Systemic changes that recalibrate healthcare governance in accordance with antiracism and equity values are necessary to provide safe and inclusive care.
Recommended Citation
Adegoke, Kola, Abimbola Adegoke, Deborah Dawodu, and Temitope Kayode. "Systemic Racism in Canadian Healthcare: A Policy and Equity Analysis." Journal of Primary Care & Community Health 16 (2025): 21501319251386672. https://doi.org/10.1177/21501319251386672
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Publication Title
Journal of primary care & community health
DOI
10.1177/21501319251386672
Comments
Graduate Student publication.
© The Author(s) 2025
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