My sister’s experience with terminal illness was shaped by many factors: pain, communication, disregard, fear, and advocacy. These often overshadowed the person at the center of it all—her. The urgency to advocate for better end-of-life care consumed what little time we had left together. It was a painful reminder that care is sometimes determined by race rather than illness.

Michelle Regnier, a registered social worker and cancer survivor working with the Wellspring Cancer Support Foundation, comments, “Some people want to make peace before passing. But too often, people and their families are forced into advocacy just to be heard.”

Canada’s reputation is that of a nation that promotes equality for all, but this ideal doesn’t hold true, particularly for Black and Indigenous people of colour (BIPOC). BIPOC are both hyper-visible and invisible in the face of systemic barriers. This means being both surveilled, policed, or punished to a greater extent than non-BIPOC people but also receiving less support from public services. This is a systemic double bind imposed on racialized people in Canada.

Bianca Beauchemin, an assistant professor in the School of Gender, Sexuality, and Women’s Studies at York University, shared her insights. “Blackness in Canada is often framed as a product of multiculturalism, yet it is not truly recognized. One dimension of this erasure is silence; we simply do not talk about it. While racism in Canada may not always appear as overt or extreme as in other nations, it still exists in insidious and systemic ways.” 

Systems of social infrastructure are all still embedded with structural racism. These acts of racism may not always be conscious, but their impact is nonetheless felt. The pain of BIPOC communities is frequently dismissed. For many, the promise of care is replaced by feelings of abandonment, anger, and grief. Their realities, needs, emotions, and agency, are often suppressed.

Many BIPOC individuals do not trust the healthcare system because they have been continuously let down by it. Black and Indigenous patients experience unique forms of medical racism rooted in separate histories and realities, oftentimes being the subject to unethical medical experiments. Generations of mistreatment intersect with medical myths, especially for Black women, who have historically been portrayed as having higher pain thresholds, a false belief based on biased, and outdated medical research. 

Studies indicate that minority groups, including Black patients, experience longer wait times in emergency departments. 91% of studies found that Black and other racialized patients wait significantly longer for assessment than white patients, even after considering factors such as hospital location, and insurance status, suggesting systemic issues beyond facility differences.  

A U.S 2023 study shows Black and Indigenous women experience unfair racial treatment, especially if they had chronic pain conditions or depression. They also had higher odds of delaying care or using the emergency department as their usual source of care rather than booking a doctor’s appointment. 

In Canada, as recently as 2024, over one-quarter of Indigenous people waited two weeks or longer for non-urgent care. One in five report unfair treatment and racial discrimination from healthcare professionals.

Regnier explains the challenges of advocacy amid ailing health, “They have to say things like, ‘I should be treated with dignity,’ or, ‘I matter.’ The system becomes central to their experience, when it shouldn’t be. That’s not fair. That’s not a collaborative, supportive, or empathetic process—and it should be.” 

The neglect from the system and the subsequent mistrust can lead to chronic stress and trauma, which contributes to poor health outcomes. Racial trauma can also intensify the grieving process for BIPOC families. 

Shanique Victoria Edwards, a registered psychotherapist specializing in racial trauma and mental health resilience, states, “Systemic shortcomings don’t just exist in hospitals; they permeate families and communities. The trauma of health inequities doesn’t simply fade, it embeds itself in our bodies, carried across generations.” This shapes the way these BIPOC communities experience illness, seek care, and navigate grief. This cyclical burden continues to demand resilience where there should instead be care.

For Canada’s healthcare system to fulfil its commitment to universal care, addressing racial disparities in respect for patients, treatment, and outcomes must become a priority. Until then, the burden of advocacy will continue to fall on those who should only have to focus on healing. 

– Suliana Beraki, Contributing Writer 

Image Credits: 

Feature Image: Photo by National Cancer Institute on Unsplash; Creative Commons

Body Image 1: Photo by RDNE Stock project on Pexels; Creative Commons

Body Image 2: Photo by Ivan S on Pexels; Creative Commons