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Racism is one of the oldest and most problematic issues in the world. Despite many voices and calls for action against racial discrimination, and indeed many were taken, racism still persists and is rooted deep inside many aspects of life, especially in healthcare, affecting millions of people of color. So what is racism, anti-racism and what can we do to remove racial inequality? Racism can be defined as “ the process by which systems and policies, actions and attitudes create inequitable opportunities and outcomes for people based on race” (What Is Racism?, n.d.), anti-racism is understood as “the deliberate act of opposing racism and promoting a society that is thoughtful, inclusive and just”. (Ministry of Citizens’ Services, 2023). To find out how to achieve anti-racism we need to know what is the current trends, and how we are dealing with it. Since its first appearance in the Spring of 1793 and became a social ideology in the 19 th century (Aptheker, 1975), racism has developed to become a system, penetrating deep into our society. Not just in health, racism appears in every facet of society. In 2022, Business Insider published 25 charts to demonstrate racism in America. The article shows that people of color are severely behind white and Asian in terms of income, poverty rate as well as educational opportunities. Figure 1 illustrates the difference in per capita income between black and white Americans. The survey shows a big income gap between black and white Americans, at the end of the survey in 2021, white Americans make 49% more than blacks. Similarly, when comparing the poverty rate between blacks and whites. Figure 2 demonstrates that African Americans suffer an extremely high rate of poverty at 19.5%, almost twice as much as Caucasians. Even in education, we see a big gap between blacks and whites. In Figure 3, only 28.1% of the black population attain college degrees while the number of the whites is 37.9%. Figure 1 – source: Census Bureau current population survey 2002–2021 – illustrated by Business Insider

Figure 2 – source: US Census Bureau– illustrated by Business Insider Figure 3 – source: US Census Bureau, 2021 - illustrated by Business Insider In terms of healthcare, racism shows to have a profound effect on patient’s quality of life. Generally, black people are less likely to access health insurance compared to white and Asian people (20% to 10%). Furthermore, minor communities also receive less access to medicine, as evidenced by the gap in vaccination between the Black and Latinx (60%) compared to white and Asian (70%). As a result, Black people had lower average life expectancies than their white counterparts. So, what are we doing to deal with the problem? There are many methods and organizations to counter racism. In Canada, major antiracist organizations are helping the black population and fight against prejudice. However, there is a need for more actions, thus, asking for the engagement of undergraduate students in anti-racism. In order to help undergraduate students become a part of the movement against racial discrimination, we need to understand allyship. Allyship can be understood as “the actions, behaviors, and practices that leaders take to support, amplify, and advocate with others, most especially with individuals who don’t belong to the same social identities as themselves” (Dias, 2023). Allyship can amplify the voices

of marginalized communities. In the context of health, racialized individuals often face disparities in healthcare access and outcomes. Furthermore, undergraduate students have different backgrounds and living conditions which will influence their way of thinking and might not understand racism and anti-racism activists. By joining in as an ally, they can learn from an environment of diverse backgrounds, giving them access to new perspectives and help them understand the importance of anti-racism. These students can use their privilege to raise awareness about issues, ensuring that the experiences of minor groups are acknowledged and taken into account in policy discussions, research initiatives, and healthcare practice. Furthermore, as an allies, we can acknowledge that racism is a systematic problem, allowing us to pinpoint and fight against systemic inequities, pushing for reforms in institutions that perpetuate racial disparities. In addition, allyship can help to find the victim of racism, helping them to overcome the issues and improve their quality of life. To encourage students to engage in allyship and anti-racism in healthcare and community, we can do two things: advocate for culturally competent healthcare practices and community partnerships. Cultural healthcare practice encourages the healthcare system to be tailored to diverse patient needs as well as debunking medical myths. In a study by Hoffman et al. (2016), 76% of white medical students have false belief in biological differences between black and white. The concerning part is that these beliefs are traced back to the 19th century as reasons to justify the inhumane treatment of slaves. This shows a lack of care for black community and people of color in general and requires a major update to fix the problem. Community partnerships refers to collaborating with community organizations to understand local needs and co-create solutions that prioritize inclusivity and address health inequities like lack of healthcare access and other inequalities. However, working as an ally means the organization needs to tackle the problem of performative allyship or “the act of outwardly appearing devoted to a cause while declining to take any major actions to support it.” (Team, 2022). Performative allyship can undermine the effectiveness of anti-racist efforts and thus, reduce the overall quality of the movement. To minimize this problem, students must prioritize authentic engagement, ensuring their actions are not driven solely by a desire to appear virtuous. Reflective practices, ongoing education, and a commitment to self-improvement are essential to avoiding the problem. Institutions, too, play a role by fostering an environment that values substantive contributions over mere symbolic gestures. By working against racism in healthcare, we can set an example for other organizations to follow and thus, tackle the problem of racism. References: 1. What is Racism? (n.d.). Australian Human Rights Commission. https://humanrights.gov.au/our-work/race-discrimination/what-racism 2. Ministry of Citizens’ Services. (2023, May 26). Anti-racism definitions - Province of British Columbia. https://www2.gov.bc.ca/gov/content/governments/multiculturalism- anti-racism/anti-racism/anti-racism-definitions

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3. Aptheker, H. (1975). Some introductory remarks: THE HISTORY OF ANTI-RACISM IN THE UNITED STATES. The Black Scholar, 6(5), 16–22. https://www.jstor.org/stable/41066354 4. Gal, S., Kiersz, A., Mark, M., Ward, M., Balevic, K., Han, Y., & Fu, A. (2023, January 3). 25 simple charts to show friends and family who aren’t convinced racism is still a problem in America. Business Insider. https://www.businessinsider.com/us-systemic-racism-in-charts-graphs- data-2020-6#theres-a-similar-disparity-at-the-household-level-lower- incomes-mean-that-the-poverty-rate-for-black-families-is-twice-that-of- white-families-7 5. Frieden, T. R., Rothwell, C. J., & Burwell, S. M. (2016, April). Health, United States, 2015: With special feature on racial and ethnic health disparities. National Center for Biotechnology Information. https://pubmed.ncbi.nlm.nih.gov/27308685/ 6. Dias, J. (2023, September 12). What is Allyship? Your questions answered. CCL. https://www.ccl.org/articles/leading-effectively- articles/what-is-allyship-your-questions-answered/ 7. Hoffman, K. M., Trawalter, S., Axt, J., & Oliver, M. N. (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proceedings of the National Academy of Sciences of the United States of America, 113(16), 4296–4301. https://doi.org/10.1073/pnas.1516047113 8. Team, R. T. (2022, May 18). Identifying and dismantling performative allyship. Rizing Tide. https://rizing-tide.com/blog/identifying-and- dismantling-performative-allyship/

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