On Nov. 10, McGill’s Desautels Faculty of Management organized the Inaugural Business Ethics Conference. This full-day conference featured three insightful panel discussions centred around ethical management in the context of systemic challenges, with a focus on the healthcare industry.
In the panel titled “Promoting Inclusion and Equity in Healthcare,” global health experts shared thoughts on the status quo in health equity from the perspective of marginalized groups such as Indigenous and queer communities.
Marcia Anderson, Vice-Dean of the Rady Faculty of Health Science at the University of Manitoba, began by highlighting the health disparities for Indigenous peoples that the COVID-19 pandemic exacerbated.
“Not only were First Nations people at a higher risk of COVID-19 but they were also at a higher risk of severe outcomes due to COVID-19 at significantly younger ages,” Anderson noted. “The median age for hospitalization for First Nations people was a full 15 years younger than that for the general population.”
Through the COVID-19 pandemic, Anderson also discussed the intertwining relationships among various social determinants of health—the non-medical factors that influence health, including race, income, education, employment, housing, and access to quality healthcare.
According to Anderson, racism is a major driver of unequal access to education, employment, and healthcare services, resulting in substantial health disparities among certain populations, such as Indigenous peoples, members of the 2SLGBTQIA+ community, and Black Canadians. Given that, Anderson emphasized the urgent need to invest in equity-focused and ethical public policies to improve health outcomes and create a sustainable healthcare system.
Following Anderson’s speech, Richard Budgell, assistant professor at McGill’s Department of Family Medicine, moved the conversation forward by expressing concerns regarding the underrepresentation of Indigenous peoples, especially Inuit people, in healthcare professions.
“If we do not have Inuit within the healthcare system, then we are not making recommendations that are informed by the Inuit. That means the form of healthcare that the Inuit receive is not the form [they prefer], and that’s a problem,” Budgell said.
For Budgell, the problem lies with the difference between Western and Indigenous approaches to care. Western medicine mainly focuses on the physical aspects of health, whereas Indigenous traditional healing embodies a holistic approach that takes into account a person’s physical, spiritual, emotional, and intellectual well-being.
Subsequently, Seeta Ramdass, associate director of the Office of Social Accountability and Community Engagement at McGill’s Faculty of Medicine and Health Sciences, expanded on the importance of racial and ethnic diversity in the healthcare workforce.
“If you are an Indigenous patient, and you happen to have on your healthcare team someone who is also Indigenous, then there is a language and cultural understanding, which can put the patient at ease right away. That actually leads to easier interactions and better health outcomes,” Ramdass explained.
Digital literacy is another barrier that makes healthcare less accessible for Indigenous populations. Due to a variety of systemic factors including lack of funding for Internet access on reservations, a 2017 report by the Brookfield Institute found that Indigenous peoples living in rural areas generally face more barriers to acquiring digital literacy than the rest of the Canadian population.
Finally, Timothy Evans, director and associate dean of McGill’s School of Population and Global Health and Associate Vice-Principal, commented on future perspectives of the education of healthcare professionals. These new approaches take seriously the consequences of various social changes, such as the COVID-19 pandemic, increasing concerns about health disparities, and healthcare globalization—a trend where organizations worldwide work collaboratively to tackle pandemics.
“[The global demographic change has resulted in] situations where countries have decreased fertility and aging populations, meaning they don’t have a productive workforce that meets their needs for all services, inclusive of healthcare services,” Evans said.
To address the healthcare system’s overall performance, Evans pointed to the need for instructional and institutional reforms in the education of healthcare professionals by encouraging the inclusion of formative and transformative learning: The development of leadership skills that allow healthcare professionals to facilitate change.
Overall, the equity panel made clear that sufficient multi-level interventions, focusing on individual, organizational, community, and policy levels, are imperative for the eradication of health disparities in Canada and worldwide.
