Black Futures/Histories Month: Black Excellence in Canadian Physiotherapy in the Face of Inequity
By: Nataliya Zlotnikov, MSc, HBSc
By: Nataliya Zlotnikov, MSc, HBSc
I. What Is Black Futures/Histories Month
To honour the accomplishments of Black Canadians, in February, we celebrate Black Futures/Histories Month.
But why do Black Canadians need a whole month? If you're not sure, keep reading (even if you think you're sure, keep reading).
We'll start off with a brief timeline of Black History Month in Canada.
Black Futures/Histories Month in Canada
Timeline data from Government of Canada, 2022.
Blog Aim and Outline
This blog attempts to frame Black Futures/Black Histories Month by placing it, as well as race and racism in Canada, in a historical and future-looking context.
We briefly address the question of whether Canada is racist, discuss and explain race and racism in Canada—specifically anti-Black racism—as well as in the physiotherapy profession, and conclude with a celebration of Black excellence in the form of a brief highlight of a few Black physiotherapists and practices.
There is so much to say and do on this subject, it is offensive to presume that one short blog will suffice. And although it is far from enough, we hope that in presenting some of these issues to our audience, we could bring greater clarity, awareness and discussion to continue to elicit change so that one day, this sort of blog becomes a mere history lesson.
- What Is Black Futures/Histories Month
- Let's Fill In the Timeline
- Is Canada Racist?
- Notes On White Supremacy
- Let's Learn About Racism
- What is Racialization?
- Let's Talk About Racism in Physiotherapy
- Let's Talk About Racism in Physiotherapy in Canada
- Physiotherapy Will Lose Talent and Clients
- Black Futures, Black Excellence
Additional Reading & Resources
II. Let's Fill In the Timeline
Returning to our Black History Month timeline, let's add a few dates to it to draw a clearer picture:
As late as 1965, in some parts of Canada, homes could not be sold, rented or leased to Black and other Black Indigenous and People of Colour (BIPOC).
And it wasn't until 1983 that the last racially segregated primary school—schools set up to keep Black students separate from White students—in Canada closed its doors (The Canadian Encyclopedia, 2022). That's less than 40 years ago!
So this nation was celebrating Black people, yet still wanted to segregate the same people being celebrated? This begs the question, is Canada's reputation of multiculturalism and acceptance solely an image? In actuality, could Canada be racist, by the same token, could the physiotherapy profession be racist?
III. Is Canada Racist?
That leaves 34% of the nation with the view that Canada is in fact, racist.
So which is it? Racist? Not-racist?
This might be one case where the majority does not rule.
Why the divergence in opinion you ask? More often than not, racism can seem invisible because people are socialized to view it as normal—particularly, those who benefit from this structure (Wegrzyn et al., 2021).
IV. Notes On White Supremacy
So who or what is a white supremacist, exactly? Are white supremacists considered so because they consider themselves so? Does one become a white supremacist by expressing a certain number of swastika tattoos? Or is the definition something more slippery and subtle? (The Atlantic, 2022)
To quote David Gillborn (2006), "By 'white supremacy' I do not mean to allude only to the self-conscious racism of white supremacist hate groups. I refer instead to a political, economic and cultural system in which whites overwhelmingly control power and material resources, conscious and unconscious ideas of white superiority and entitlement are widespread, and relations of white dominance and non-white subordination are daily reenacted across a broad array of institutions and social settings."
V. Let's Learn About Racism
Racism does not only come from white supremacists.
When most people think of racism, they tend to think about personally mediated racism. But there are other levels of racism.
Let's very briefly look at the 3 levels of racism.
3 Levels of Racism
Image information from Jones, 2000.
In her paper, Levels of Racism: A Theoretic Framework and a Gardener's Tale, Dr. Camara Phyllis Jones, an American physician, epidemiologist, and anti-racism activist, presents an allegory that illustrates the relationship between the 3 levels of racism that may guide our thinking about how to intervene to mitigate the impacts of racism on health.
This allegory is presented in the video below:
A Gardener's Tale - A Story About Systemic Racism
VI. What is Racialization?
Unlike racism, racialization is the process of making race real in our societies.
It is the social process of judging, categorizing, and creating difference among people to establish and justify socially created hierarchies based primarily on physical characteristics in relation to whiteness (Vazir et al., 2019).
Race was created historically to justify the subordination of people defined as non-White in order to advance the social and economic interests of people defined as White. Over time, the structure of racism has become deeply entrenched and normalized throughout societal institutions, including education and healthcare. (Hughes et al., 2021).
Racialized groups (i.e., non-White) experience race as a key factor in their identity, and experience inequality via the process of racialization (Vazir et al., 2019).
VII. Let's Talk About Racism in Physiotherapy
In Canada, there is a lack of research on diversity and racism in the physiotherapy profession. Most research on this subject comes from the UK and USA. This research has shown that physical therapy is perceived as a White profession (Vazir et al., 2019).
While the whiteness of the PT space is apparent or visible to Black people, this whiteness may not be apparent to those whose identities align with the orientation of the space (i.e., those who are white) (Wegrzyn et al., 2021).
But how can a profession be white? It's not as if physiotherapy schools blatantly say "you can't be a therapist unless you're White," and there are Black physiotherapists. So what makes PT a white profession?
National statistics on race are not collected by the physiotherapy profession in Canada (Vazir et al., 2019).
In the US, however, where such information is collected, data shows that the most common "race group" among physical therapists is White; making up 73.9% of all physical therapists. Comparatively, only 3.9% of PTs are Black or African American (Physical Therapists Demographics and Statistics in The US, 2022).
Here are a few of the data some of the UK and USA studies identified:
VIII. Let's Talk About Racism in Physiotherapy in Canada
Now, let's shift our focus to Canada, where 3 recent Canadian publications, Vazir et al., 2019, Hughes et al., 2021, and Wegrzyn et al., 2021, explored the perspectives of racialized Canadian physiotherapists and physiotherapy students and their experiences with racism in the programs and profession.
Their findings were consistent with those of the UK and USA studies and provided some eye-opening personal accounts, just a few of which we've included below.
On assimilating to whiteness to better fit in, one participant described how they change their voice when working with White adults:
On dealing with patients' and colleagues' assumptions based on their race, one participant who is a senior executive explained:
On institutional and experiences of personally-mediated racism:
Participants often reported an unwillingness of white faculty members to engage meaningfully on issues of racism, feeling that they had no one to advocate for them when facing discrimination based on their race. Furthermore, they described a lack of safe avenues for support through the PT program or placement regarding concerns about racism.
One participant described how the school responded when dealing with a preceptor who the participant felt was giving them a negative evaluation due to race:
Another student explained how they had to respond to incidents of racism from patients on their own:
A Black Canadian physiotherapy resident we spoke with had this to say about PT in Canada:
IX. Physiotherapy Will Lose Talent and Clients
Situations like the ones above can be responsible for a loss of talent, enthusiasm and clients for the physiotherapy profession.
The quote below illustrates this point.
In the 2021 Wegrzyn et al. paper, study participants discussed how the exposure of "Black as different" limited entry into professional training programs.
As an example, a physiotherapist participant discusses a Black colleague who decided to reject his offer to a PT program after learning more about the racial construct of the profession as White:
(Wegrzyn et al., 2021)
Furthermore, we must avoid working with BIPOC like they are White. When we treat BIPOC patients like they are White, we run the risk of missing many important things and render ourselves unable to provide client-centred care (Vazir et al., 2019).
We believe that White PTs should take the necessary steps to educate themselves on how to correctly treat BIPOC—and of course, BIPOC is not a single homogenous category—hint, respect is a great place to start though. At the same time, making the PT profession "less White" is a crucial step to providing comfortable, client-centred care to racialized peoples in Canada.
X. Black Futures, Black Excellence
So far, the profession has been lucky. The whiteness of PT has not dissuaded all Black people from joining. The drive and desire to improve health and well-being have been stronger than the challenge presented by racialization. But it is that much more difficult for the reasons discussed above and more.
This Black Histories/Black Futures month, we decided to highlight a few of these Black physiotherapists and Black-owned physiotherapy practices in order to celebrate their excellence and promote Black-owned.
The WombCare Clinic is dedicated to providing culturally sensitive and compassionate pelvic and women’s health care throughout one’s life course and breaking the silence around key women’s health issues such as menstruation, uterine fibroids, PCOS, endometriosis, pelvic pain, incontinence, pelvic organ prolapse, prenatal/postpartum support, and menopause; especially for marginalized communities who lack access to qualified healthcare professionals.
Founded by Amoy Jacques, WombCare is a reproductive health and wellness agency seeking to conduct research with health agencies across Canada and create equitable programs, and policies for women, particularly those from marginalized communities.
Co-owned by registered physiotherapist Michael Williams, Trent Health in Motion is a private multidisciplinary clinic that offers state-of-the-art facilities and a wide range of health services in Peterborough, Ontario.
Their services include physiotherapy, pelvic health physiotherapy, chiropractic care, massage therapy, athletic therapy, hydrotherapy, dietitian consultation, sports medicine, and on-site sports event coverage.
As a health clinic operating in the private sector, they recognize that access to care is not equitably distributed, and have made it a priority to work with marginalized groups in their community to develop programs to make high-quality health care services more easily accessible.
Physiotherapist and Clinic Director of Endeavour Sports Performance and Rehabilitation, Dan’s unique approach allows him to successfully treat many patients who have had unsuccessful treatment elsewhere. His passion for advancing physiotherapy led him to teach courses internationally, participate in 100’s of continuing education hours each year, and mentor promising future and current therapists.
Dan remains active in the community, providing care to athletes in a sports setting. He works with young athletes, high school teams, and basketball academies, among others.
XI. Additional Reading & Resources
To read more about anti-racism and equity in PT, we invite you to take a look at our blogs, Anti-Racism & Allyship for Rehab and Movement Professionals and Resources for Deepening Understanding of Racism in the Context of Physiotherapy and Rehabilitation.
As well as our course, Anti-Racism & Allyship for Rehab and Movement Professionals.
A Few Other Organizations Include:
Open Dialogue Canada
A non-profit organization, Open Dialogue Canada is a platform for Healthcare Providers committed to improving the quality of care experienced by Black, Indigenous and People of Colour (BIPOC). Open Dialogue aims to build the capacity of the healthcare sector to address the impacts of racism through education, dialogue and engagement, so that we may become better providers of equitable healthcare for BIPOC communities.
National Association of Black Physical Therapists, Inc.
A nonprofit organization with the primary focus of increasing opportunities for the African Diaspora in physical therapy.
Ontario Rehab Alliance Black Network
This network aims to address anti-Black racism within the rehabilitation sector, promote cultural humility and responsiveness, and advocate for equality and inclusion of Black clients and rehabilitation providers.
OTEA - Occupational Therapists for Equity Advancement
An independent network of Occupational Therapists (OTs) from historically marginalized groups, founded by Black, Indigenous and 2SLGBTQ+ OTs that collectively support the increase of inclusion, diversity, equity and access within OT in the GTA.
Not Just in February, but Everyday
We strongly believe that "this dialogue shouldn’t just be isolated to the shortest month of the year, but that we should continually strive to understand each other, eradicate prejudices, and challenge societal norms that have propagated racial oppression". -Jeannette Johnson (University of Guelph, 2021)
Date written: 31 Jan 2022
Last updated: 16 Feb 2022