Healthcare leadership in Hamilton, Mississauga, Brampton and Canada lacks racial diversity — McMaster study

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Published April 7, 2022 at 9:25 pm

Health-care leadership in Canada has achieved gender equity — but racial diversity is lacking, says a study led by a medical student at McMaster University in Hamilton.

Anjali Sergeant, who is in her third year of medicine at McMaster’s Michael G. DeGroote School of Medicine, is the first author on a research paper entitled, “Diversity among health care leaders in Canada: a cross-sectional study of perceived gender and race,” which was published last month in the Canadian Medical Association Journal (CMAJ).

The study included leaders of Canada’s largest hospitals and all provincial and territorial health ministries. All told, the reviewers and authors included more than 3,000 leaders from 135 institutions, and compared the proportion of racialized health care leaders with the general population rate from the 2016 Canadian Census. Their period of observation over three months, from April to July of last year.

The authors found that Ontario has a particularly large gap between racialized health-care executives and its racialized population. The representation gap, as it is known, is 20.7 per cent in Ontario. Manitoba is higher, at 27.5.

The reported gaps are smaller in other provinces, including British Columbia (14.5), Quebec (12.4), Newfoundland and Labrador (11.6), New Brunswick (7.6) and Prince Edward Island (7.3). Alberta, Saskatchewan and Nova Scotia each have one leadership team that oversees all hospital networks, and the researchers found each province has fewer than five racialized healthcare leaders.

Racialized and marginalized people tend to experience worse health outcomes than the general population. That trend has been borne out in during the COVID-19 pandemic. Black and racialized Canadians, for instance, have had disproporiately high rates of COVID-19.

Sergeant said the inequities trickle up from the younger levels of the education system.

“We need to make our environments more inclusive and supportive of all people starting at the early education level, and carrying it forward through to higher levels of training,” she said.

“This is significant, because we know that individuals who are racialized experience worse health outcomes and might experience discrimination within our healthcare systems,” she said.

A flow of cultural sensitivity might also be a two-way street. Dr. Zain Chagla, an infectious disease physician in Hamilton with McMaster and St. Joseph’s Health System, recently coauthored an essay that contended policies set by politicians — who rely on health-care leaders — are exacerbating vaccine hesitancy, particularly among racialized and lower-income communities.

Gender equity improves

The researchers found that the percentage of healthcare leaders who are female virtually 50 per cent or higher across the country. In Ontario, Manitoba and Quebec, where leadership teams exist at each hospital, reviewers perceived 49.9 per cent of more than 2,650 leaders. Only 9.2 per cent in those three provinces presented as racialized.

In Alberta, Nova Scotia, P.E.I. and Saskatchewan, where administration is centralized, it was believed that 50 per cent of health ministry leaders were female. In B.C., New Brunswick and Newfoundland and Labrador, where hospital leadership is regionalized, leadership was perceived as 56.1% female.

The study is available at CMAJ.ca.

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