Dismantling barriers for Black and immigrant Canadian health

Bukola Oladunni Salami is a self-confessed “dabbler.” 

She founded and leads the African Child and Youth Migration Research Network, a group of 35 scholars finding ways to improve the health of African migrant children and youth. Her research was instrumental in bringing a mental health clinic to Edmonton’s Africa Centre. She founded the Black Youth Mentorship and Leadership Program at the U of A. She researches the mental health of displaced people, temporary foreign workers, refugees, undocumented migrants and Black Canadians, and she is currently investigating Black Canadians’ COVID-19 vaccine hesitancy and exposure to COVID-19 misinformation and the health of climate refugees.

“Dabbler” might be the wrong word. It belies Salami’s expertise and the many real-world contributions she has made to migrant and Black health through her research, much of which has been motivated by her experiences coming to Canada from Nigeria at 16 and experiencing racism.

“One thing that I’ve always had to grapple with as a black person is that people see me and they don’t think I look like someone who is intelligent,” she said. “I have been very resilient. A lot of black populations are very resilient, but sometimes the racism that you experience, it’s so strong that it overwhelms whatever resilience you have. It clouds everything.”

A professor in the Faculty of Nursing at the U of A, Salami has been profiled in the book 100 Accomplished Black Canadian Women (2018), listed as one of Edmonton’s Top 40 Under 40 by Edify Magazine, and led over 25 funded research projects.

Salami and I discussed her ongoing work investigating racial health inequality and new research into the COVID-19 pandemic’s toll on Black Canadians.

Your research has found that Black Canadians and immigrants of colour have a harder time taking care of their mental health than white Canadians. Why do you think this is so?

Racism stands to be one of the most significant influences on the mental health of Black Canadians and Black youths, not just in terms of the fact that Black people experience racism, but also how they internalize the racism they experience. It starts to actually shape their self-concepts, which in turn shapes mental health.

There’s also a big wealth gap. Because of inflation, everyone’s income generally increases four per cent every year. It’s been like that for every single population in Canada, apart from Black men. Black men’s income has remained the same and has not increased with inflation.

When people want to get mental health services, and it’s not a psychiatrist, you need to pay, $200, $100. Who has $200 or $100 when you’re still looking for a dollar or two to buy food for your kid? So mental health is put on the back burner.

What has your research discovered about the mental health of immigrants to Canada?

My past research found that immigrants’ health declines after a period of five to 10 years in Canada. A lot of immigrants report their mental health is better when they first arrive.

Canada tends to bring in the most healthy, well-educated immigrants. If you have serious mental health issues, maybe HIV/AIDS or cancer, you can’t come to Canada as an immigrant; you can come as a refugee but not as an economic immigrant.. So immigrants come to Canada with their PhDs and then they end up cleaning or driving a taxi. The downward occupational mobility that immigrants experience has consequences. It has an influence on your mental health, your self concept, your income, and on what resources you have access to. 

What are you learning about Black Canadians’ experiences with COVID-19 and about vaccine hesitancy in Black Canadian populations?

The COVID-19 pandemic has shed light on some of the disparities that Black Canadians experience. We know that if you’re black in Canada, you have a higher chance of getting COVID-19.

A lot of workplaces are like a cappuccino: white on top and black underneath. And that has implications. When people on the front-lines are Black, those are people that are having the vulnerable contact.

In terms of COVID-19 vaccine hesitancy, there was a research project that I was involved in that did a survey of Blacks and non-Blacks and found that Black Canadians were about 20 per cent less likely than other groups to get the COVID vaccine.

Why does this seem to be the case?

One of the issues is being able to take time off work to go get a vaccine. If you’re low in the hierarchy of the workforce or in a precarious job, you might not be able to take time off.

Low trust in healthcare professionals was another central reason why people were not going to get the vaccine. Black populations have historically been treated as guinea pigs. For example, there was a U.S. study that recruited Black men and followed them to look at the natural course of syphilis, but the researchers didn’t tell the men they had syphilis even when medication was available to treat it. 

The Black Opportunity Fund, of which I’m a member, organized a town hall and got together Black professionals during the vaccine period to talk about how to address COVID-19 in the Black community. There were 400-500 people in the town hall. One of the things I heard during our breakout session was, “Is this another experiment?” 

Past unethical research with Black Canadians has consequences for COVID-19 uptake.

What do you think needs to change for communities of colour to have better mental health outcomes?

We need to have more community-based mental health services. We need to ensure that people have access to not just psychiatrists, but also psychologists. The waitlist now is too long.

The other thing is recognizing racism as a determinant of health. We need to focus policies on addressing racism.

We’ve also found that community belonging contributes to mental health. One program people talk about is parenting programs. When you have a parenting program, where kids start talking together, then parents start talking together, and people start creating communities.

I think we need to focus more on how we really nurture and generate vibrant communities within our society.

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Bukola Oladunni Salami is an affiliate of the Sustainability Council. Learn more about how you can become an affiliate.