Discrimination, prejudice, racism and health status

Culture and ethnicity, biologic endowment and gender are all determinants of health.   They are all components on which individuals may be discriminated.  Hence discrimination and determinants are foundational in assessing health.

While visible minorities are  the mostly widely acknowledged and perhaps studied of the discriminating characteristics, religion has historically been one of the most divisive, and the one that perhaps has resulted in the most human suffering.  Centuries of bloodshed between Christians and Muslims from the crusades to ongoing civil strife in several countries today have demonstrated how characteristics other than gender and skin colour may profoundly affect our safety and wellbeing.

Canada’s record on gender equity remains relatively poor, despite premiership positions being held by women in the largest provinces and covering 85% of the population.   Currently ranked  21^st and the US 22^nd, the placing for Canada has slipped from 14^th in 2006.   world Economic Forum gender report 2012  

Discrimination takes many forms.  The challenge to the reader is to determine if you are truly discrimination free.   At the extreme level, overt racism and acts of hatred are manifest.  Perhaps this interpretation of discrimination justifies many lesser obvious and potentially damaging acts.

Less overt are symptoms such as:

• ·         Inappropriate Terminology: Using language that can be offensive, even where such language might be perceived as commonly acceptable. 
• ·         Paternalism:  Addressing issues with paternalistic approaches where certain groups are involved
• ·         Commission:  Disinterest in inequity issues suffered by specific groups.
• ·         Avoidance behaviour:  Feeling discomfort or actively avoiding communicating or engaging members of the group
• ·         Ignorance:  Lack of effort to become further educated on the traditions or issues facing a group.

In reality, we are all members of minorities and not only potentially the instruments of discrimination but also the recipients.   Think of the number of settings where your opinion or some personal characteristic causes a reaction because it is not carried by the majority, and the sense of disempowerment you feel when your perceptions are ignored or debased.  

Nationally and globally significant strides have been made in reducing the manifestations of discrimination – but given the impact on individuals and communities, it is an issue on which silence is not acceptable.