“If there's shouting after you, keep going. Don’t ever stop. Keep going. If you want a taste of freedom, keep going” Harriet Tubman, n.d.
A new year is often a time for reflection, and the making of resolutions. I begin with the words of renowned resistance fighter Harriet Tubman, who crossed the colonial boundaries of Canada and the United States in the service of Black liberation. Her words are an important reminder that anti-racism is a journey - not a destination. My use of the word journey here is deliberate…To quote the late James Baldwin, a Black American gay activist and writer across many genres, “A journey is called that because you cannot know what you will do with what you find, or what you find will do to you” (excerpt from Raoul Peck 2016 documentary, I am not your Negro).
We inherit the legacies of that which has come before.
We live in a present created by dispossession, genocide, enslavement, and ongoing white settler colonial projects and heteropatriarchy.
So, what has Critical Race Theory got to do with it?
Well, Critical Race Theory (CRT) emerged in the US in the late 70s early 1980s among a group of racialized legal scholars (e.g., Derrick Bell, Mari Matsuda, Kimberlè Crenshaw, and Richard Delgado), to examine the roles that race, and racism played in American legal structures in the post-Civil Rights context. Their work was political in nature, growing alongside movements for social justice and equality that recognized that history and context inform the character and structure of social life.
Rather than being one perspective or approach, CRT advances our understanding of the meaning and significance of race and racism. It is a collection of theoretical positions and disciplines that self-consciously views the construct of race through a critical lens, posing new questions on the persistence, if not the intensification, of race and the multicultural “colour line” where we live now. It has subsequently been taken up across a range of disciplines such as sociology, education, feminist studies, and more recently in health studies.
Some of CRT’s guiding principles are that race is a sociohistorical construct and that racism is pervasive and not an aberration. CRT recognizes that current inequalities and institutional arrangements and practices are tied to past and present systems of racial exclusion, hostility, and violence such as dispossession, genocide, enslavement, settler colonial projects, and immigration laws. It is a lens that sees link between racism and mass incarceration, housing, education, income, and health inequalities.
CRT is a purposeful intervention – one that explicit names race. This identification is important because it means that we can explicitly identify the existence of racism. The Disruption of All Forms of Racism Policy is aligned with CRT in a number of ways, beginning with acknowledgement of the continuing significance of race and the prevalence of racism in many systems in Canadian society, including health care. Crucially, the Policy also goes beyond a focus on individual behaviours but focuses on structures, as one tool as part of organizational cultural change.
With respect to health care, CRT offers a framework to disrupt the false binary that exists between the social sciences and health sciences, by enabling us to challenge claims that health care is race-neutral, objective, and “colourblind.” Consequently, CRT also enables us to think about how racism is a public health crisis that disproportionately impacts Indigenous, Black, and racialized communities.
In addition, the forthcoming revisions to to the Canadian Medical Education Directives for Specialists (CanMEDS) provide an opportunity to address the racism inherent in its existing framework. Similarly, this year the General Standards of Accreditation for Institutions with Residency Programs are scheduled to make changes to make them more inclusive of Indigenous and Black perspectives and address anti-Indigenous and anti-Black racism(s).
Anti-racism work involves the active process of acting to challenge not only one’s own biases and prejudices, this work also involves the dismantling of the policies/social relations/attitudes/practices that promote and/or sustain racial inequality and racial oppression.
Together Critical Race Theory and anti-racism work can be a meeting ground – a site of disruption and of possibility – a combination that has the potential to create community, solidarity, and advance movements for health equity and related movements for social justice.
A new path forward towards racial justice is challenging, but possible if we commit to new learning, building relationships, cultural shifts, and structural change.
The process/journey of working in solidarity involves unlearning and building relationships that are based in transparency, consistency, and accountability.
Our futures are linked; the potential from strategic solidarity would be transformative.
Delia Douglas, Sume Ndumbe-Eyoh, Kannin Osei-Tutu, Barbara-Ann Hamilton-Hinch, Gaynor Watson-Creed, Onye Nnorom, and OmiSoore H. Dryden; on behalf of the Black Health Education Collaborative. (2022). Black Health Education Collaborative: the important role of Critical Race Theory in disrupting anti-Black racism in medical practice and education. Canadian Medical Association Journal (CMAJ), 194 (41) E1422-E1424; DOI: https://doi.org/10.1503/cmaj.221503.
Mari J. Matsuda, Charles R. Lawrence III, Richard Delgado, and Kimberlè W. Crenshaw. (1993). Words that wound: Critical race theory, assaultive speech, and the First Amendment. Westview Press, Boulder, CO.
Kannin Osei-Tutu, Whitney Ereyi-Osas, Priatharsini Sivananthajothy, and Doreen Rabi (2022). Antiracism as a foundational competency: reimagining CanMEDS through an antiracist lens. CMAJ. 194 (49) E1691-E1693; DOI: https://doi.org/10.1503/cmaj.220521.
Rahel Zewude and Malika Sharma. (2021). Critical race theory in medicine. CMAJ, 193 (20) E739-E741; DOI: https://doi.org/10.1503/cmaj.210178.