1 of 14

Nothing About Us Without Us

Intersectionality in community

April 2024

2 of 14

Agenda

Mi’kmaq community voice

Collaboration
Engagement
Development

Health Equity Framework
Intersectionality

History
Public Health System Relevance
Applying intersectionality in public health

Anti-oppression approach

Critical reflection

3 of 14

Cathy Martin – working with Mi’kmaq

Collaboration

Engagement

Development

4 of 14

Health Equity Framework Background

The Health Equity Framework (HEF) was released in July 2023.
The HEF was a specified deliverable in the Dismantling Racism and Hate Act, passed Spring 2022.
The legislated framework is a guide for NS health practitioners and partners on strategies, approaches, and operations of using Equity, Diversity, Inclusion, Reconciliation, and Accessibility (EDIRA) and Anti-Racism/Anti-Oppression (AR/AO) lenses to identify, reduce and eliminate racism and discrimination within the health system.
Based on an initial health system inventory, initiatives are already in place for 34 of 35 priority actions under the HEF; nearly all are ongoing.

5 of 14

Better Patient reporting system for racism and discrimination
Workplace racism and discrimination action plan
Workforce equity data and census initiative
Health Equity Lab @ NS Innovation Hub
Health Equity Charter
Health system policy review

Health Equity Framework

2024/2025 Health System Key Priorities

6 of 14

Health Equity Framework Implementation Approach and Guiding Principles

Guiding Principles

Equity, Diversity, Inclusion, Reconciliation, and Accessibility (EDIRA)
Anti-Racism/Anti-Oppression (ARAO)
Accountability
Collaboration and Alignment
Reconciliation/Nation-to-Nation

Implementation Approach

Building on work already started by DHW, NSH, IWK, OHPR, OAMH and SLTC
Developing project management infrastructure to manage and track the work
Prioritizing engagement of communities and partners in all HEF work
The Implementation team has prioritized seven system-level action priorities for FY2024/2025

7 of 14

Health Equity Framework Implementation Partnerships

Key Community Institutions

Academia

Private Companies

Municipalities

Extended Health System

Other NS Government Partners

Tajikeimik

Unions

Colleges

Associations �

Core Health System Partners Department of Health and Wellness

Nova Scotia Health

IWK

Office Health Professional Recruitment

Office of Addictions and Mental Health

Department of Seniors and Long Term Care

8 of 14

Intersectionality History

“Intersectionality is a lens through

which you can see where power comes

and collides, where it interlocks

and intersects. It’s not simply that

there’s a race problem here, a gender

problem here, and a class or LGBTQ

problem there.”

– Kimberlé Crenshaw

19^th century – 1851 Sojourner Truth

“Ain’t I a woman” – and black

20^th century – 1989 Kimberlé Crenshaw

discrimination understood as occurring only within a single category at a time

- excluded black women

E.G. Black people to be men, women to be white.

Critical race theory

race is an invented concept that is given meaning through racial hierarchy

Intersectionality is not a new concept

In the 19^th century, Sojourner Truth a black woman spoke the line “Ain’t I a woman” Sojourner Truth being a black woman.

In the 20^th century, Kimberle Crenshaw, largely accepted as the legal scholar who coined the term intersectionality looked at mainstream cases and examples and showed that when the literature referred to black people, they meant men. When the literature referred to women, they meant white women. Through her work outlining the exclusion of black women the term intersectionality is born and evolves to represent multiple identities beyond race and gender.

Critical race theory, where critical race theory holds that race is an invented concept that is given meaning through racial hierarchy – This hierarchy is produced, maintained and strengthened by various systems and institutions distributing the power according to the group’s position within the hierarchy.

This is closely linked to intersectionality, and many critical race theory scholars seek to examine how racial inequities are also affected by other dimensions of oppression

Sexism, classism, homophobia. Through this – they often use intersectionality to deepen their understanding of social injustices.

9 of 14

Intersectionality Reflection Question

How might the approach to decision making, planning and operation be flattened and not consider intersectionality?

10 of 14

Intersectionality Public Health System Relevance

Can provide a lens to examine how various structural and social determinants of health interact with one another

Provide a focus on overlapping systems of oppression as well as human resistance in the face of oppression

An Intersectional approach to Public Health System

Ground itself in pursuit of social justice
Break away from narrow, one-dimensional understandings of discrimination and marginalization

A flattened or whitened intersectionality is an intersectional approach that omits race by denying its relevance, leaving whiteness unexamined and or separating race from its larger systems of power.

For example : a whitened approach to intersectionality may focus on the collection and reporting of health-related data by categories such as sex and sexual orientation while avoiding race-based data or using ethnicity as a substitute for race.

A flattened intersectionality lacks focus on social justice and power –

For example : intersectional approach may use COVID 19 data by race and neighborhood to design a vaccination campaign geared towards black communities. – Sounds good so far?

However, the approach to intersectionality has been flattened if the campaign does not take into account systemic, deeply rooted barriers to vaccine uptake, including white supremacy in the health system. The intention may be good, the execution could still be flattened/whitened

In order to avoid this and to truly apply an intersectional approach to the public health system, it needs to be grounded in the pursuit of social justice and to break away from narrow one dimensional understandings of discrimination and marginalization.

11 of 14

Intersectionality Reflection Question

Whose voices are being heard in decision-making? Who’s are excluded?

12 of 14

Applying Intersectionality Public Health System

Anti-oppression approach

Critical reflection

Unpack biases, values, beliefs and norms

How do these relate to systems of power and oppression – drive our decision making?

Inclusion isn’t just inviting someone to sit at your table. It’s believing they belong there. – Mia Carella

Critical reflection is a way we can practically employ an anti-oppression approach.

Because saying we are not oppressing anyone is great, saying we don’t want to oppress anyone is also great, but how do we actively work against oppression.

If you’re wondering how to critically reflect, consider what we’ve just gone through in this session.

The questions we raised as a group were designed with this practice in mind.

If you were uncomfortable with the questions or felt they didn’t apply to your work, consider the past and how decisions you were a part of may have unconsciously excluded some. Consider the definitions and blind spots, these may require careful consideration or help from peers.

The objective is not to shame or point fingers, the objective is grounded in humanness, love, compassion and acceptance.

From there, as long as you are honest with yourself, you will begin to critically reflect on the topic of intersectionality and apply it in your work.

Combining this reflective practice, the theory, definitions, and policy change we can change the structural barriers

13 of 14

Intersectionality Reflection Question

How will you engage more authentically with communities experiencing multiple forms of oppression and marginalization?

14 of 14

Thank you

Raoul Tan-Yan

Raoul.tan-yan@novascotia.ca

Cathy Martin

catherine.martin@dal.ca

Questions?