Unintentional racism by health practitioners most dangerous racism, researcher says

A Toronto research scientist is speaking at the University of Winnipeg today about what she says is the deadliest form of racism, which many don't even realize exists — unintentional racism.

"Unintentional racism is a differential action — treating people differently, taking action that preferences one group of people over another based on how you identify them racially," said Dr. Janet Smylie of the Centre for Research on Inner City Health at St. Michael's Hospital.

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She's trying to send the message that unintentional racism from health practitioners is the most dangerous form of racism.

Smylie's decision to study unintentional racism was sparked by the Brian Sinclair inquest, where she was an expert witness. She reviewed the evidence on best practices for caring for indigenous patients in the emergency room. 

Sinclair, a 45-year-old homeless double amputee, was referred to Winnipeg's Health Sciences Centre emergency department with a blocked catheter and a urinary tract infection. He died in the emergency department waiting room on Sept. 21, 2008, after sitting for 34 hours without receiving care.

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During the inquest, Smylie realized the care providers who were at the hospital are very compassionate, she said. 

"People actually wanted to be kind, but they were making assumptions that were incorrect, so they had faulty diagnostic logic," she said. 

During her research for her paper First Peoples, Second Class Care, she found that patients who experience unintentional racism can't necessarily concretely identify it. 

"Sometimes we hear particularly from indigenous patients that they felt disrespected or not comfortable," she said. "I don't believe there's very many health or social service providers that wake up in the morning and say, 'Yeah, I'm going to be racist today. I'm going to provide different access and treatment options to people based on their racial group,' but in fact, we know that it happens."

As an example of differential decision-making, Smylie cited a 2014 study published in the Canadian Medical Association Journal that found First Nations people in Alberta are less likely to get imaging of their coronary arteries after a heart attack and have worse long-term survival than non-First Nations people. 

"For some reason this human condition results in people recognizing people that look like them and treating them better than people that look differently," she said.

Studies have shown it's possible to train our brains to stop being unintentionally racist, she said.

Her trick is called the Janet Smylie Toronto subway exercise.

"When I'm in Toronto on a subway, I might see a person that looks like maybe they're wearing clothes that are a little worn," she said, adding that she might make up a story in her head about how this person is experiencing poverty. "Then I challenge myself and say, 'OK Janet, maybe they're a millionaire and they just like that pair of worn-out jeans.' That's stereotype replacement."

Other things people can do is to take someone else's perspective and get to know the individual, she said.

Smylie is speaking at the University of Winnipeg at 12:30 p.m. Wednesday in Convocation Hall.