Primary care in Canada is suffering and doctors want input on how to fix it
By
Dr. Tara Kiran is a family physician and researcher at St. Michael's Hospital, Unity Health Toronto, and the Fidani Chair in Improvement and Innovation at the University of Toronto. She is the national lead for OurCare and host of the podcast Primary Focus.
I still remember the hope I felt in 2002 when I chose to become a family doctor. It wasn't the most popular career path in medical school, but for me, it was a calling — the chance to build lasting relationships with patients and be there through every stage of life.
More than two decades later, it's heartbreaking to see so many people in Canada still struggle to get that kind of care.
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Toronto Star
17 hours ago
- Toronto Star
Primary care in Canada is suffering and doctors want input on how to fix it
By Dr. Tara Kiran is a family physician and researcher at St. Michael's Hospital, Unity Health Toronto, and the Fidani Chair in Improvement and Innovation at the University of Toronto. She is the national lead for OurCare and host of the podcast Primary Focus. I still remember the hope I felt in 2002 when I chose to become a family doctor. It wasn't the most popular career path in medical school, but for me, it was a calling — the chance to build lasting relationships with patients and be there through every stage of life. More than two decades later, it's heartbreaking to see so many people in Canada still struggle to get that kind of care.
Winnipeg Free Press
2 days ago
- Winnipeg Free Press
Black Canadians have highest avoidable hospitalization rates: StatCan data
TORONTO – New data from Statistics Canada shows Black Canadians have had the highest rates of avoidable hospitalizations in the country — something experts say underscores the need for more equitable health services for the Black community. A report released June 18 shows that over an eight-year period, Black Canadians were admitted to hospital for treatable health conditions such as asthma, diabetes and hypertension at higher rates than other racial groups and non-racialized people. In the most recent data collected in 2023/2024, Black men and boys were admitted at a rate of 272 hospitalizations per 100,000 people while Black women and girls saw a rate of 253 per 100,000 people. Other racialized people including South Asian, Chinese and Filipino Canadians had significantly lower rates. The lowest was among the Chinese population, in which men and boys had 65 hospitalizations per 100,000 people, and women and girls recorded 52 per 100,000 people. Non-racialized people had the second-highest rate of avoidable hospital admissions in 2023, reaching 257 per 100,000 among men and 226 per 100,000 among women, the report states. Notisha Massaquoi, an assistant professor of health education and promotion at the University of Toronto, says the data shines a light on the health equity crisis for Black Canadians who face significant barriers to primary care. '(This is) a population that has experienced an enormous amount of racism in the health-care system,' said Massaquoi, who studies access to health-care services for Black Canadians in the Greater Toronto Area. 'There's a lack of trust in terms of going to a primary health-care setting or going to see a primary health-care provider, and when a community has experienced a lot of marginalization in the health-care system, what they do is avoid going until it's too late.' Black Canadians might avoid seeking routine care because there is also a lack of Black health-care providers, said Massaquoi, noting better survival rates and health outcomes when a Black patient has a Black primary caregiver. StatCan data shows that in 2023, the most updated information available, 72 per cent of Black Canadians had access to a primary health care provider. That's compared to 84 per cent of non-racialized Canadians. The Canadian Medical Association says it doesn't keep track of the number of Black physicians in the country, but data published in 2020 by the Academic Medicine Journal — the peer-reviewed journal of the Association of American Medical Colleges — estimated that 2.3 per cent of practising physicians in Ontario were Black in 2018. StatCan's report doesn't provide the specific reasons for hospitalizations, but a member of the senior leadership team at Women's College Hospital in Toronto says Black populations are disproportionately affected by chronic illnesses. The reasons for that are complicated, said Dr. Cynthia Maxwell, a past-president of the Black Physicians Association of Ontario. Maxwell said chronic illnesses can sometimes be traced to hurdles navigating the health-care system. Some Black communities also have fewer grocery store options, making access to nutritious food difficult, or are in areas more exposed to environmental toxins, which can lead to higher rates of respiratory problems. Massaquoi and Maxwell both stressed the need for more Black health-care providers and Black-oriented clinics, saying many patients feel more comfortable visiting environments where there's less risk of racism. Such an increase could also help train other doctors on the specific needs of Black patients. 'We will likely never have enough Black health-care providers to provide access to all Black community members, so it is important for all allies in the health system to engage in and learn about cultural safety and competencies that will help drive better health-care outcomes,' Maxwell said. Maxwell linked less access to primary care to higher mortality rates of serious diseases, such as among Black women with breast and cervical cancer. 'We know Black women have less access to screening for conditions such as breast cancer and cervical cancer, which are major issues and have high morbidity and mortality in Black communities,' she said. 'A condition is identified typically in the primary care setting,' she said, noting that's where a patient is referred to a specialist for serious conditions. Maxwell said it was important to collect better race-based patient data in order to identify issues unique to each community. 'Without the … race-specific data, you can't really get to the nuances of what the particular issues are within a community and what it means for a community to be disproportionately affected, either by a health condition or by the outcome of treatment for a health condition,' Maxwell said. Massaquoi said Black health-care advocates have 'constantly' begged for better race-based data collection. 'What we want to see as members of the Black community are the interventions that are going to be developed and designed so we're no longer just getting this trauma type of data that keeps telling us over and over in every manner how badly we're doing.' This report by The Canadian Press was first published June 29, 2025.
CBC
3 days ago
- CBC
Indigenous people's health tightly tied to speaking their own languages, review finds
Social Sharing A new research review out of the University of British Columbia (UBC) has found that Indigenous people experience better health outcomes when they speak their traditional languages. Researchers analyzed 262 academic and community-based studies from Canada, the United States, Australia and New Zealand, and determined 78 per cent of them connected Indigenous language vitality with improved health. Studies found positive outcomes ranged from better physical and mental health, to increased social connections and healing, to greater educational success. One 2007 study out of B.C. revealed that youth suicide rates were down in First Nations communities where larger amounts of people spoke Indigenous languages. "Part of the reason why we undertook this literature review in the first place was because almost everyone that we speak with in Indigenous communities who is working on language revitalization report that reclaiming and learning their language has played a big role in their own personal health," said co-author Julia Schillo, a PhD student in UBC's linguistics department. She did the literature review, Language improves health and wellbeing in Indigenous communities, alongside a team of UBC researchers, with help from the University of Toronto and the University of Sydney. One of their major findings was the importance of health care being offered in an Indigenous language, with proper translation. Without that, patients were at risk of being diagnosed incorrectly or misunderstanding medical instructions, and reported feeling alienation or a lack of respect. In one example, Inuit children were misclassified on cognitive tests because their testing was in English, not Inuktitut. The review found connections between language and well being run deeper than direct communication, too. For instance, Schillo says physical health improves when Indigenous people participate in traditional sports and consume a traditional diet — and that both of those activities correlate with speaking traditional languages. "Based off of the literature review, but also people that I've talked to, it has to do with how language revitalization plays into identity and feelings of belonging and connection," she said. "It has a lot to do with healing from trauma, and intergenerational trauma that's related to the Indian residential school system." Those findings hold true for Chantu William, a young Tsilhqot'in language speaker and second generation residential school survivor who says learning her language growing up supported her mental health and identity as an Indigenous person. William, who wasn't involved in the study, is an early childhood educator and a policy analyst in her nation. She's working on language handbooks to give to parents at the local daycare, "for the language to stay inside the home." She co-developed language curriculum with her mother, as part of the Youth Empowered Speakers Program, with the First Peoples' Cultural Council. William says the idea for the language handbooks came from Māori relatives in New Zealand, who have similar programming that started in the 1980s, and are strong language speakers. "I feel so honoured to be able to teach and learn [Tsilhqot'in] with my preschool and day care kids and the youth in my life. I feel so grateful that I'm in this space, in our community sharing the language." William says hearing youth and elders speak the language with each other makes her happy, and that for her, "it gave direction in life." Johanna Sam, who is also Tsilhqot'in and an assistant professor at UBC in the department of education, says that if governments want to support Indigenous health, language revitalization needs to be part of the conversation. "Indigenous languages are so much more than words; they carry our laws, our stories and our knowledge systems that have sustained our nations since time immemorial," she said, noting that some words in Indigenous languages cannot be translated to English. Sam says she didn't have a lot of opportunity to learn her language being a first-generation residential school survivor, but she grew up hearing older generations in her family speak it and that uplifted her pride and identity. She wants to see more investment in Indigenous language curriculum and more options for health care to be provided in Indigenous languages. It's something the review's researchers are also calling for. They're asking all levels of government to provide long-term funding for Indigenous language revitalization and to recognize speaking the languages as a social determinant of health.
