A policy brief commissioned and funded by the Public Health Agency of Canada proposes adding racism to the Canadian Population Health framework as a determinant of health.

In this brief, racism is defined as a belief that race is the primary determinant of human traits and capacities and those racial differences produce an inherent superiority of a particular race. Racism affects people not only at an interpersonal level but also through the broader structures of society, most notably in the systems of education, justice, media, policing, immigration, employment and the health care system.

Linking this understanding of race to the reality of racism is the concept of "racialization," which refers to the social process whereby certain groups come to be designated as different and consequently subjected to differential and unequal treatment. Lack of access to opportunities, marginalization and exclusion among these groups suggest that their perceived racial membership plays a significant role in shaping their collective experience – that is, individuals are racialized rather than merely being in a racial group. Unlike the term "visible minorities," which Canada's Employment Equity Act defines as "non-Caucasian in race or non-white in colour," the term racialized makes clear that race is not an objective biological fact but rather a social and cultural construct that potentially exposes individuals to racism.

Racism directly impacts on health and mental health, primarily through the increased and prolonged stimulation of the body's physiological stress response. Stress resulting from the daily lived experience of racism can cause negative emotional states such as anxiety, depression and lowered self-esteem/identity which can in turn have direct effects on biological processes that increase the risk of disease and mortality. The direct impact of racism on health behaviours includes resorting to high-risk health behaviours, such as substance abuse and self-harm and other negative coping responses, as well as delays in seeking healthcare.
 

The brief presents six recommendations:
 

1) increase public awareness of racism and its impacts on health, access to health care and quality of health care;
 

2) implement and enforce policies and procedures to eliminate institutional racism in all sectors;
 

3) undo institutional racism in health policy, administration and practice;
 

4) reduce the negative impact of racism on health;
 

5) allocate funding for research and monitoring activities;
 

6) consider the formation of a Standing Committee, similar to the Commission for Racial Equality in the United Kingdom.
 

See "Racism as a Determinant of Immigrant Health," March 30, 2009, at canada.metropolis.net.