Everyday racism experiences, healthcare access, and self-rated health: A study of Black men in Ontario, Canada.

Abstract

Objectives: We explored the determinants and health-related outcomes of everyday racism (EDR) experienced by Black men in four Ontario cities in the context of HIV.

Methods: Data were obtained from a CIHR-funded study that examined HIV vulnerability and resilience among Black men. The sample size was 866 (Ottawa [n = 210], Toronto [n = 343], London [n = 157], and Windsor [n = 156]). We applied the generalized linear model (GLM) to estimate the effects of EDR and other factors on (i) difficulty accessing healthcare and (ii) self-rated health. Next, using GLM, we determined the predictors of EDR. We measured difficulty accessing healthcare (difficulty accessing = 1, otherwise = 0) and self-rated health (good/very good/excellent = 1, otherwise = 0) as binary outcome variables. EDR was measured with the short version of the Everyday Discrimination Scale.

Results: Of the Black men per city, 75‒85% experienced at least one of the five dimensions of EDR. EDR was associated with increased difficulty accessing health care, and fair to poor self-rated health (p < 0.05). EDR increased with residency in a smaller city (e.g. Windsor relative to Toronto), years of living in Canada, housing adequacy, traditional masculinity score, and individual resilience (p < 0.05). Collective resilience predicted reduced EDR.

Conclusion: Racism experiences persist among Black men in Ontario and remain a key determinant of healthcare access and well-being among Black men. A multipronged approach, including ending anti-Black racism through transformation of organizational and governmental policies, promoting collective resilience within communities, and encouraging social reconstruction of the Black masculine ideologies, may be a practical approach to improving their health outcomes.