Evidence of meeting #131 for Status of Women in the 44th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was risk.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Nadine Caron  Professor, As an Individual
Alethea Kewayosh  Director, Indigenous Cancer Care Unit and Indigenous Health Equity and Coordination, Ontario Health
Juliet Daniel  Professor, The Olive Branch of Hope Cancer Support Services
Amanda Sheppard  Senior Scientist, Ontario Health
Guylène Thériault  Physician, Canadian Task Force on Preventive Health Care
Donna Reynolds  Physician, Canadian Task Force on Preventive Health Care

11:45 a.m.

Conservative

The Chair Conservative Shelby Kramp-Neuman

Thank you very much.

Leah, you have the floor for six minutes.

Leah Gazan NDP Winnipeg Centre, MB

Thank you so much, Chair.

Dr. Daniel, you spoke about racism as a social determinant of health. Dr. Caron spoke about impacts of colonization. I would say that for indigenous populations, racism in the health care system is alive and well. The mistreatment of indigenous people in the health care system is quite pronounced, including a man, Jason Kennedy, who had the wrong leg amputated this month in the hospital. I think the real mistrust of the health care system is based on facts and based on experience.

I want to start with you, Dr. Daniel. I want you to expand on how racism becomes a social indicator of health in the current context.

Prof. Juliet Daniel

As I said, the American Association for Cancer Research, or AACR, has been one of the leading associations studying all cancers for over three to four decades. A lot of the data that many of us in Canada and around the world use is their data, because they've been collecting ethnicity-based and race-based data since 1975, which is kind of bizarre, considering what we think about American culture.

As I said, in 2020, I believe, they released their report saying that racism is now a social determinant of health. They were looking not just at historical trauma but also at current trauma, such as racial profiling. Whether it's when you go into the health care system or whether it's when you're driving your car, there's racial profiling in any scenario.

They also look at the harm within the communities of environmental racism, such as many of those communities, Black and/or indigenous, being physically located in places where there are biohazards, etc., as well as perhaps toxic dumps being placed near these communities. They have very little access to health care, and then they're exposed to toxic chemicals.

Leah Gazan NDP Winnipeg Centre, MB

When you're talking about racial profiling, would you say that racial profiling also occurs in the health care system?

Prof. Juliet Daniel

Definitely. It definitely does occur.

Leah Gazan NDP Winnipeg Centre, MB

How so?

Prof. Juliet Daniel

For example, I recently met several young Black women who felt a lump. They were under the age of 30. They were dismissed by three physicians who said they were too young, that they can't have cancer because they're too young. Their concerns about the lumps in their breasts were dismissed. In one case, the lump was dismissed for almost two years.

I also met a young indigenous woman in 2018 who first felt a lump at the age of 22. She wasn't taken seriously until she was 24, and by that point, it was advanced stage breast cancer, and she had to have a double mastectomy at the age of 24. That there is racism.

Leah Gazan NDP Winnipeg Centre, MB

By just looking at research, would you say there's a double standard of care for Black people, indigenous people, people of colour and Caucasians?

Prof. Juliet Daniel

I am not a physician. I can't speak to what goes on in the hospitals. I can only speak about the women or the men who have told me of their lived experiences. We're publishing a study on that as well. There are definite differences in how they're treated by the health care system.

I think it depends on the region. I don't think it's the same in every single hospital or every single province, and we have to be aware of that. We're not saying that it's in general.

Dr. Caron is ready to respond to this, but we have to be aware that there are systemic barriers and racism that we are aware of and have experienced ourselves.

Leah Gazan NDP Winnipeg Centre, MB

I'm going to move over to you, Dr. Sheppard, because you mentioned the first nations and Inuit health branch and providing equal access for indigenous women to get mammograms. The two-tiered health care in this country is a critical issue when there's one for indigenous people and then one for everyone else.

How is a lack of access to health care placing indigenous women more at risk for not being diagnosed at earlier stages of cancer?

11:50 a.m.

Senior Scientist, Ontario Health

Dr. Amanda Sheppard

I think the evidence is pretty clear, no matter who you are, that prognosis is better with an earlier detection. I did highlight that what we've seen in Ontario is poor survival, even with stage 1 diagnosis, so I think there are two red flags to really support early access for first nations, Inuit, Métis and urban indigenous women. I did refer to remote communities earlier, but urban indigenous women are also having barriers to access mammography and other care.

Just to add to the point earlier about racism in the health care system, with some qualitative work that we've done in the province of Ontario, repeatedly we saw comments about how women were being pushed out of the health care clinic and being told to take Tylenol when they were expressing concerns about pain and fears about different health conditions.

I'll let Alethea speak more to the issue.

11:50 a.m.

Conservative

The Chair Conservative Shelby Kramp-Neuman

That was excellent. Thank you.

Unfortunately, MP Gazan's time is up.

At this point, that does conclude our panel. On behalf of the committee, I'd like to thank all of our witnesses for your appearances here today and for sharing your testimony.

Because we have separated it into two different panels, it's a little bit of a different structure from what we're familiar with.

Thank you very much, witnesses, for being here to share your testimony.

Prof. Juliet Daniel

Meegwetch.

Thank you for this opportunity.

Emmanuella Lambropoulos Liberal Saint-Laurent, QC

Madam Chair, I just have one question before they log off.

11:50 a.m.

Conservative

The Chair Conservative Shelby Kramp-Neuman

Okay. Before you log off, I will allow one short question.

Emmanuella Lambropoulos Liberal Saint-Laurent, QC

It's not even a question to them. It's more for you, procedure-wise.

Usually when we have two split rounds, like two rounds of panels, there's another round for the Conservatives and then another round for the Liberals. Usually it's an extra five minutes for each. I don't know if the second panel is just one panel opening up with five minutes of comments and only one witness, because that might actually allow us to—

11:50 a.m.

Conservative

The Chair Conservative Shelby Kramp-Neuman

I welcome that, but we have taken care of that housekeeping. There was an intention to have extra rounds for both parties, but the time is not on our side and we have a full second hour. Unfortunately, that's where we're going to leave it.

At this point, we will suspend for about five minutes to transition to our—

Leah Gazan NDP Winnipeg Centre, MB

Can I ask you for a point of order just before they leave?

11:50 a.m.

Conservative

The Chair Conservative Shelby Kramp-Neuman

Sure.

Leah Gazan NDP Winnipeg Centre, MB

I know the briefs were due earlier on. I'm wondering if we have agreement of the committee to send briefs if they have anything else to add, because this is the only panel that we have had with indigenous and Black women.

11:55 a.m.

Conservative

The Chair Conservative Shelby Kramp-Neuman

The actual briefing deadline was October 21, which is some time back. We are still willing to accept, from the analyst's perspective, all the documents with regard to reference documents. They are still more than welcome to be submitted.

Lisa Hepfner Liberal Hamilton Mountain, ON

On the point of order, Chair, I would agree with Leah.

We extended the study to hear from more witnesses, so the original deadline doesn't make sense, given that we've heard from extra witnesses—

11:55 a.m.

Conservative

The Chair Conservative Shelby Kramp-Neuman

If you'd like to put a motion forward....

Leah Gazan NDP Winnipeg Centre, MB

Can I say a motion?

11:55 a.m.

Conservative

The Chair Conservative Shelby Kramp-Neuman

If there's consent around the room, we can extend the deadline. I don't think we need to go to a formal vote to extend the deadline for briefs. If it's the wish of the room, we can extend that.

What date do you find reasonable? Is it another couple of days?