November 4, 2025
The Empire Club of Canada Presents
Whose Health Counts? Improving Health Outcomes for Black Women and Girls in Canada
Chairperson: Carrie Bois, 1st Vice-Chair, Empire Club of Canada; CEO C+B Consulting
Moderator
Nam Kiwanuka, Host & Producer, TVO’s (MIS)Treated
Panellists
Dr. Cindy Maxwell, Vice President, Medical Affairs & System Transformation; Lead Medical Executive, Women’s College Hospital
Dr. Modupe Tunde-Byass, Inaugural President, Black Physicians of Canada (BPC); Fellow of the Royal College of Obstetricians and Gynecologists (UK and Canada); Staff Obstetrician-Gynecologist, North York General Hospital
Dr. Bukola Salami, Full Professor, Department of Community Health Services, University of Calgary; Registered Nurse; Tier 1 Canada Research Chair in Black and Racialized People’s Health
Head Table Guests
Kearie Daniel, Founder & Executive Director, The Black Women’s Institute for Health
Joss Reimer, Former President, Canadian Medical Association
Welcome Address by Carrie Bois, 1st Vice-Chair, Empire Club of Canada; CEO C+B Consulting
Good afternoon, everyone. I have to start the afternoon by acknowledging how fabulous this room is. I was just waiting outside and watching everybody enter. And I just have to say that the mix, the demographic today is incredible and inspiring, and what a great way to spend a Tuesday afternoon. So I just wanna start off with that, and thank you for attending. I’m Carrie Bois, First Vice Chair of the Board at the Empire Club of Canada, and your host for today’s event.
To formally begin, I want to acknowledge that we are gathering on the Traditional Treaty lands of the Mississaugas of the Credit, and the homelands of the Anishinaabe, the Haudenosaunee, and the Wendat Peoples. I encourage you all to learn more about the Traditional Territory on which you work and live.
Today’s event would not be possible without the generous support of our sponsors. The Empire Club is a nonprofit organization, and our sponsors generously support the club, and make these events possible, and complimentary for our online viewers to attend. So please join me in thanking our Lead Sponsors, McKinsey & Company, and the Canadian Medical Association. And to our Supporting Sponsors, thank you. Accelerate Auto, and Shoppers Drug Mart. We also deeply appreciate the ongoing support of our Lead Season Sponsors, Bruce Power, Hydro One, and National Bank Financial Markets. And our VIP Reception Season Sponsors, Ellis Don, McKinsey & Company, and the Ontario Road Builders Association, and Waste Connections of Canada. And finally, thank you to our Media Sponsor, Toronto Star, and our AV Partner, Bespoke Audiovisual.
Now today, if you have a question for our speakers, please scan the QR code found on our program, or through the Q&A function, if you’re online. For those of you online, if you require technical assistance, please use the chat feature.
Now, I’m so pleased to see you here for an important conversation. This morning, I was up early, I was on the website looking for the report, and then I saw the countdown, it said 19 hours, and I was doing the mental math of when that would be. So, when my dog got me up this morning at 5 a.m., I said, “Okay, this is how I’m gonna start my morning.” What an incredible way to start my day. I’m so pleased with this conversation, and I hope that the conversation won’t just stop today, that it will just take place on this stage, what will continue afterwards.
We have called today’s event, “Whose Health Counts, Improving Health Outcomes for Black Women and Girls in Canada,” and we couldn’t be here without the Black Women’s Institute for Health, an organization that brings attention to a reality that’s too often overlooked. How the places we live, the work that we do, and the opportunities we’re given all shape our health. For Black women and girls in Canada, those factors are made even more complex by systematic barriers, gaps in research, and experiences of anti-Black racism. All of this leads to unequal access to care and poor outcomes, and those things demand our urgent attention.
This afternoon, we’ll hear about a groundbreaking national report, Voices Unheard, that tells these stories in the form of hard data, and more directly in the voices of lived experience. The report confronts all of us with an urgent question. How can Canada’s health systems, workplaces, and institutions do better? The good news is, we have the people here who can help us begin to answer that question.
Today, we bring together an incredible group of experts, who’ve dedicated their careers to build stronger, fairer systems for everyone. They bring both data and lived experience to this conversation. As I said, I hope this is a conversation that continues, but it is also part of a continuing conversation we have already been having. Back in February, 2022, we heard from a panel that included Adaoma Patterson, the President of the Jamaican Canadian Association. She said something that really stuck with a lot of us. Healthcare and other systems really can’t make any difference without involving the people who are impacted. That’s why today’s event is so important and so necessary. This report, the first of its kind, is taking us another step down the road towards better equity and outcomes for all Canadians, including Black women and girls.
To get us started, please join me in welcoming our Event Partner, Kearie Daniel, the founder and executive director of the Black Women’s Institute for Health, whose leadership and vision have brought us all together for this important conversation. Before we turn to the panel, we’ll first hear from Kearie. Kearie Daniel is a national leader in nonprofit strategy, systems transformation, and equity advocacy. She founded the Black Women’s Institute for Health to advance the well-being of Black women and girls through community-led advocacy, data, and culturally-grounded programs that reimagine how systems serve people. Her career has spanned healthcare, education, and child welfare, always focused on confronting institutional harm, and creating pathways to justice. She’s led communications at Cancer Care Ontario, Humber River Hospital, and for the One Vision, One Voice initiative, amplifying the voices of Black families in Ontario’s child welfare system. Kearie was also the inaugural executive director and co-founder of Parents of Black Children, now a nationally recognized education advocacy organization, and the creator of Woke Mommy Chatter, a platform that honours the realities and strength of Black motherhood. Please join me in welcoming Kearie Daniel to the stage.
Opening Remarks by Kearie Daniel, Founder & Executive Director, The Black Women’s Institute for Health
Good afternoon, everyone. It’s lovely to look out and see you all here, and I really hope and I know that the conversation that we have this afternoon will be transformational. And just the first step that we’re taking into transforming and shifting the conversations, and the lives of Black women and girls. And I wanna thank you, Kearie, for that generous introduction, as well.
I am so pleased to be here this afternoon to share with you our critical findings from Voices Unheard, the first ever national survey focused on the health and wellbeing of Black women and girls in Canada.
But I first want to express my gratitude to Ken Emerson and the team at the Empire Club and to the chair of the board, Dr. McIvor. Thank you. Thank you for recognizing the importance of this work. Thank you for recognizing the missing data, and these long-ignored stories. When I first met Dr. McIvor, one of the first things he said to me was that Black women are invisible. And that statement caught me off guard, because of how violently true it was, and it is. And I thought it was profound that we as Black women have lived with this invisibility all of our lives. We’ve lived with the erasure of our experiences, the silence that surrounds our pain, the deep absence of our truths and policy, in practice and in data. But I thought it was interesting that that could be seen so clearly, and so understood when you’re looking for it. And that’s what our Voices Unheard survey set out to do, put visibility to what has been invisible for far too long, to shade in the shadows of who we are as Black women in Canada, and our experiences.
So, I want to pause here, and share a video that marks the launch of our report. When we launched the survey, we began last year with the stories of three Black women. And now as we launch the results, we’re gonna do this again, but with three new voices, three stories and three lives.
[VIDEO:]
[Zandra Pinette]: I suffered from chronic suicidal ideation, including periods of self-harm for approximately eight years of my life. I have lived without these dark and injurious thoughts for approximately three years, and it has been very freeing and liberating for me. What helped me was working with trauma-informed clinicians, letting go of guilt and shame, learning to love myself, and using coping strategies I learned in therapy and applying them to my day-to-day life.
[Dieulita Datus]: My story with living with fibroids left me isolated, it left me with unbearable pain, but most of all, it left me feeling as if my health matters were dismissed by the healthcare system for many years. I didn’t feel as if I was listened to, I didn’t feel as if my health was taken into consideration, which led to me having a full hysterectomy in 2020 at a very young age, which has had a significant impact on my health and my family. I’m sharing my story so that other Black women can know that we need to advocate for ourselves, we need to push for answers, and most importantly, we need to know that our stories and our pain is real and valid.
[Nadia Thompson:] I completely lost count of how many doctors I have seen, but I can count on one hand how many doctors have listened to me, and really tried to help me. And so most of the time, I ended up just having to figure things out on my own, because I felt like I had no other choice.
[END OF VIDEO]
Kearie Daniel
I think hearing the voices directly from some of the women that completed the survey is so impactful, and I wanna thank Changemaker PR Firm, for helping us put that video together, and working really hard to get voices from across the country reflected there. So, thank you for that. The data in the video is historic, we’ve heard this. This is the first time in the entire history of this country that Black women and girls have been asked in a structured and intentional way about our health across the full spectrum of social determinants.
Now let me be clear, this is not to say that there hasn’t been work that’s being done in the Black health space. We are deeply grateful to Black-led community agencies like the Black Health Alliance and Women’s Health Women’s Hands, Women’s College Hospital has also been doing work in this space, and many others who’ve led and lived this work. But to collect this type of desegregated data from coast-to-coast, focused solely on Black women and girls across every domain of life that impacts our health, this is just the beginning, and it truly has been a labour of love. We are a new charity, we’ve been in operation since 2023. We are small, but we are mighty. And we’re doing this because we can no longer afford to be ignored, invisibilized, or dismissed.
Black health is not a market to corner, it’s not a trend to catch, to focus on for the right now, it is life and death. Black women are dying because we have, literally, not been counted in the data. We have not been counted in the waiting rooms, we are not counted in the clinical trials, and then we are dismissed and not counted again when we seek care. When we launched the survey in October 2024, we knew we needed between 385 to 1,000 responses to make the research viable, based on the percentage of Black women in Canada. We received 1,337 completed surveys. On top of that, we held workshops, we did town halls and focus groups, and engaged 629 more Black women for a total of 1,966 voices, almost 2,000 Black women from across Canada. And when we asked respondents whether they would be interested in going public with their experiences, over 500 women said yes.
So, for those of us who are part of Black communities, we know what it is to answer and say yes to sharing your personal stories, to sharing the stuff that you might just talk about with your friend, or your parents, or your family, right? 500 women said I wanna go public, I wanna share, I want my voice heard. That’s how critical this work is, that’s how much they want to share and talk about what these experiences have been.
So, these are voices that were once ignored, now lifted and now counted. So, what did we find? Let me paint you a portrait of the average respondent. Most are in their mid-30s to mid-50s, the age where women are the anchors of families and communities. Nearly all have completed post-secondary education, with one in three holding a bachelor’s degree, and close to another third holding a post-graduate degree. Close to 60% are working full-time in permanent roles, contributing meaningfully to Canada’s labour force and economy. Many work in caring sectors that hold this country together, including education, healthcare, public service, and community work. One in three is married, another third are single, many parenting and caregiving, while also holding the weight of work and community care.
But despite all of this, the education, the work, the resilience, 27.6% of Black women in this country told us that they have had thoughts of self-harm. That is more than one in four. Almost seven times the national average. That’s an alarm bell. Sixty-seven percent of Black women living with chronic health conditions are receiving treatment and care. They’re doing everything the system asks of them, yet one in three are saying that their concerns are dismissed, or not taken seriously when they seek that care. And 42% have told us that they have delayed or avoided seeking healthcare due to concerns about how they would be treated as a Black woman. And this dismissal, this erasure, is consistent across the report. 66% of Black women told us that they felt dismissed by healthcare providers, and it follows Black women into their workplaces too.
In our sub-report examining Black women working in the healthcare system across the greater Toronto area, over 40% told us that they had felt pushed out of jobs because of discrimination, racism, or lack of support, and more than half reported direct experience with racism and discrimination on the job. As one participant said, “When talking about anti-Black racism, “it was dismissed and not taken seriously, “and when expressing interest in professional development, “I was always excluded.” These are women who are healers, women who hold others in crisis, women who make the system run, and yet they’re being broken by the very system that they serve. And we cannot heal our community in a system that refuses to care for its healers. And one third of Black women in this country, by the way, work in healthcare, one third.
Our Voices Unheard report and sub-reports do not just reveal a crisis in care, they reveal a crisis in humanity, in our humanity. And Black women are the ones paying the price. It’s not theoretical, it’s happening right now. So we’re asking Whose Health Counts, because clearly, it hasn’t been ours.
Now, in a room like this, full of decision makers, and funders, and policy influencers, researchers, and community leaders, I want to say clearly, there are calls to actions in this report for all of you. We end the report with recommendations endorsed by grassroots and institutional partners alike. I’m gonna highlight just a few.
Collect and fund desegregated race-based data across all health systems and programs, data that is co-designed and controlled by Black communities. Fund community-based Black-led initiatives that center the experiences of Black women, girls, and gender diverse people. Ensure intersectionality is a requirement in policy design, program development, and service delivery, not an afterthought. Develop and support culturally relevant mental health supports that reflect our values, languages, and lived experiences. Create accountability mechanisms within healthcare systems for addressing anti-Black racism and gender discrimination.
We cannot continue to treat Black women without accounting for race, and all its implications, and we cannot ask Black women to survive broken systems, then praise us for our resilience instead of fixing the harm. And we cannot keep making excuses for inaction and lack of data. We’ve made it easy for you. We have the data now. Our hope is to be able to do this every three years, and build on that data. Use the QR code on the screen, where you can visit our website, healthforallBlackwomen.com, where you can download the report, read the report, share it, see the recommendations, act on them. We built this, all of this, as a counter-narrative to say we see ourselves, we hear each other, and we matter.
And let me end with this. Black women are not just statistics. We’re not just patients. We are the ones who advocate for our children. We care for our elders, and we keep our communities going. And for too long, our health has not been counted. But this work, this report, is about to change that, and it’s about changing that. And now, it’s my honour to introduce our panel of brilliant Black women, all of whom are leading in their fields of work and advancing equity for Black people across Canada.
Our moderator for today is Nam Kiwanuka. Nam is an award-winning journalist, co-host of The Agenda with Steve Paikin, host of TVO’s The Thread and The Agenda in the Summer, and she also hosts and produces TVO’s acclaimed podcast, Mistreated, which explores women’s health through powerful stories and sharp reporting. Joining Nam are three leading experts who have each shaped Canada’s health landscape in meaningful ways.
Dr. Cindy Maxwell, Vice President of Medical Affairs and System Transformation at Women’s College Hospital, and Lead Medical Executive at the University of Toronto. Dr. Maxwell is a physician, a researcher and educator, whose leadership has advanced equity and systems transformation across Ontario.
Dr. Bukola Salami, full professor in the Department of Community Health Sciences at the University of Calgary, registered nurse and tier one Canada research chair in Black and racialized people’s health. Dr. Salami has led more than 90 funded studies focused on the well-being of Black, immigrant ,and racialized people and founded Canada’s first university-based mentorship program for Black youth.
Dr. Modupe Tunde-Byass, Inaugural President of the Black Physicians of Canada, Fellow of the Royal College of Obstetricians and Gynecologists in both the UK and Canada, and Staff Obstetrician and Gynecologist at North York General Hospital. Dr. Tunde-Byass is a leading voice for equity and quality improvement in maternal care, and has been widely recognized for her work in reducing disparities in reproductive health outcomes for Black women.
Please join me in welcoming Nam, and our distinguished panellists, and let’s begin the conversation Whose Health Counts.
Nam Kiwanuka, Host & Producer, TVO’s (MIS)Treated
Hello, good afternoon. It was hard to sit and to hear some of those things. I don’t know how everybody here felt. I’d love to get your reactions to it. But I actually just wanted to kind of give a big shout out to the Empire Club of Canada. Kearie mentioned that these conversations, Black women, we have them in the group chats, within our own circles. But if you look to the United States, I think the last number that I saw, over 300,000 Black women had been laid off in the last few months, this pushback against DEI. I think our communities have kind of been pushed into slogans, but our health matters, and I think it’s so important that the Empire Club is having these discussions in the open. So, thank you so much for hosting us today.
I’m very excited to speak to all of you, but because we are talking about—and we also want questions from you, so if you have questions, please send them my way, and I will incorporate them into my questions. I would love to speak to you all about how, why you got into healthcare, and what it means to you. Dr. Tunde-Byass, I will start with you.
Dr. Modupe Tunde-Byass, Inaugural President, Black Physicians of Canada (BPC); Fellow of the Royal College of Obstetricians and Gynecologists (UK and Canada); Staff Obstetrician-Gynecologist, North York General Hospital
So, thank you so much for everyone who’s been here, especially our learners, and also policymakers. Being in medicine for me has been something that I dreamt of as a child, growing up in Nigeria, and caring about people, and also putting myself out there. It’s been something that’s always been a joy for me, and contributing to the system. My work has taken me globally from Nigeria to United Kingdom, where I did my residency, and before coming here, to complete another residency, and to look at how there is health disparity coming from Africa, where you never knew racism, and then coming to another country where there’s so much disparity. So, all those things have shaped the way I look at myself, and I look at other people in healthcare.
Unfortunately, there’s very few Black women in my position, in my capacity, and so, that under-representation is so, it cuts across a lot, and I think for—it disadvantages Black women a lot. And not being able to find somebody who truly understands where they are coming from has been a disadvantage. So, those are some of the things that I’ve seen in medicine. But medicine has been a passion of mine, and if I have to do it again, I will still be a physician. Thank you.
Nam Kiwanuka
And we’re lucky for that. And Professor Salami, what about you?
Dr. Bukola Salami, Full Professor, Department of Community Health Services, University of Calgary; Registered Nurse; Tier 1 Canada Research Chair in Black and Racialized People’s Health
So for me, just like Dr. Byass, I’ve always wanted to be in healthcare. Back home, I had family members that were doing well. When I came to Canada, here in Toronto, first on Front Street, and then later on at Malvern, I experienced my mom, who was a single mom, she had received her bachelor’s degree here from the University of Winnipeg, went back to Nigeria where I was born, and then came back to Canada. Everyone asked for a Canadian experience. She didn’t have Canadian experience. And that was actually a code for we don’t want you here, because you’re non-white. And even though she has a bachelor’s degree, and my dad had a master’s degree, they never worked in a healthcare, they never worked in a position that required a degree. My mom worked as a cleaner for the longest time, my dad worked as a cab driver, even with a bachelor’s degree from McMaster, with great grades, and a master’s degree from Fairleigh-Dixon University.
So, when I came here, the mission that I had is, you get your bachelor’s degree, you get your master’s degree, you’re going to be still, you know, like many of the women, downward occupational mobility. So, I wasn’t as much motivated. I was lucky, because very, very early on, I got introduced to the first mentorship program—mine is not the first, the mentorship program I created is the first in Western Canada. But the first mentorship program created for Black people, atuniversity-based mentorship program was at the University of Toronto. Changed my perspective, and that was a collaboration….
Nam Kiwanuka
Why did it change your perspective?
Dr. Bukola Salami
It changed my perspective because everyone that I saw there when I went to church, when I went, were all people that we’re highly educated, but were not practicing in their profession. And it changed my perspective, because then I could see, oh, no, I shadowed a gynecologist, I shadowed a pediatrician, and that changed my perspective to say, actually, you can get educated, as a Black person, and still be able to achieve and be higher up in the profession. And I think that’s one of the things that we miss in Canada, the mentorship of some of our Black people, our girls, and also as they progress.
We know, for example, in Canada, the Black women, contrary to popular opinion, have a high, African immigrant women, have a high level of education. The challenge we are seeing is it’s not getting passed down the generation. So, we are seeing our girls, our boys, going in the path of what job their parents are doing, rather than what education their parents are working in. And that has to change. So, the inequities that we’ve reported in this finding, and we could say Black women experience inequities, they are dismissed, but it’s not just a thing for Black women. It has implications for their children, and it has implications for their children’s children. So, the socioeconomic outcomes of their parents does pass down generations. And that’s why it’s so important to address this.
Nam Kiwanuka
It also denies all of us the genius based on racism, right? Because you think about all those people who could have done something great, if not for those barriers. I just wanted to mention, there’s no time on here. I mean, I can talk for five hours, but I know there’s timing. There’s no time on here, so I don’t know if this needs to be changed. Just flagging that. Dr. Maxwell, the same question for you. Why did you pursue a career in healthcare, and what has your journey been like in healthcare?
Dr. Cindy Maxwell, Vice President, Medical Affairs & System Transformation; Lead Medical Executive, Women’s College Hospital
I can think of several experiences, really from a young age, I think that pointed me in the direction of a career in healthcare. And so, I will share a personal story. When I was a teenager, there was an instance where a family member had a wound, a complication from a surgery that they had on the abdomen. And because of the remoteness where we live—so I’m from a small town in northern New Brunswick—the clinical provider who could travel to your home to help with the wound dressings could only do so at most once a week, perhaps twice a week. But this particular wound was of such severity that it required daily dressing changes. And so, it turns out that it was me that learned how to do this.
Nam Kiwanuka
How old were you?
Dr. Cindy Maxwell
I was 16. I was 16, and I learned how to dress a wound, and a surgical wound. And so, I remember starting for the first time and thinking, okay, if I’m going to clean this wound, I’m really worried this is going to hurt the person, and why is it that when you are treating a wound that you put dressing into the wound. Shouldn’t it close? Why would you wanna put something into the wound to help it actually heal? But as I started to learn about the healing properties, and how one manages a wound, I began to understand the power of healing, and how the power of touch, and the power of going through steps to help a person achieve better health, how those could unfold.
I discovered that, in fact, the person felt better as the wound continued to be dressed and treated, and it actually didn’t cause them pain. And then after several weeks, that wound closed. And so, what I take away from that experience is that there is a power of healing and a power of touch that you can learn, that you can teach other people, that if you live in a remote community or a remote area, access to the kind of care that you need may be challenging. And so, you know, you may have to be resourceful with the individuals that are either in the family fold or in the community to help with certain aspects of the care. And if I think about what I do now, both in my clinical work and in my administrative and organizational work, I think I’m an innovator in surgical care, as it pertains to obstetrics, and I lead systems change to create access to care. So, I think that there are elements of those experiences that I carry with me to this day.
Nam Kiwanuka
Solving puzzles.
Dr. Cindy Maxwell
Exactly.
Nam Kiwanuka
Dr. Tunde-Byass, you mentioned these challenges that you had, and this report highlights that one in three Black women in Canada works in healthcare, yet they’re not in the boardrooms or the C-suites. The three of you are. What has been the most challenging aspect of oftentimes being the only one in those rooms? I’d like to ask you all of that question, but I’ll start with you.
Dr. Modupe Tunde-Byass
Yeah, I think it’s always a challenge, you know, being the one and only. It’s lonely, and also, you feel isolated. But I think one important thing that Kearie mentioned, as a Black woman, you have to love yourself, and you have to understand that you have the capability, and you also have the experience to share. So, being in this position, I can tell you it needs a lot of advocacy, and also a lot of work, to ensure that one, you know what you’re talking about, two, you’re standing firm, and three, you can also challenge the status quo.
Nam Kiwanuka
Do you feel like you can’t make mistakes in that position, though?
Dr. Modupe Tunde-Byass
Of course. You know, sometimes you do, and sometimes, you know, you look at are you at the glass ceiling, which a lot of us are. And you rightly mentioned, even in the healthcare system where you find a lot of Black women, majority of them do not make it past managerial position, when they hit the glass ceiling. However, they feel that past that, they go through the phenomenon of glass cliff. They are in the boardroom or they’re doing incredible job that nobody wants to do, yet they’re not supported, and if they make any mistake, you know, they’re down into the cliff. So, you always have that at the back of your mind, which is challenging doing the work, and also at the same time, you know that you’re over-analyzed in everything that you do. But the work is so much that you just keep pushing. And having allies are very important. People who do not look like you, but they are ready to support you, they are ready to yield the floor, they are ready to use their social capital to ensure that the work that you’re doing is meaningful, and that’s why we’re here today with Empire Club.
So, and also having colleagues like Cindy, Bukola, there are many of us, so the work gets a lot, and there’s a lot of burnout. But being able to piggyback on each other, and asking for help is very useful. So, that’s how I’ve been able to manage, and you know, moving from being the inaugural president of Black Physicians of Canada, I’m now the president of Federation of Medical Women of Canada, so that’s another intersection, right, within the same healthcare system. So it’s very interesting, but it’s work that needs to be done, and we need to continue doing it.
Nam Kiwanuka
And Professor Salami, the same question.
Dr. Bukola Salami
Yeah, thank you so much. And yes, you rightly point out that, you know, someone once told me that the healthcare profession is like a cappuccino. And the person said it’s, you know, Black and Brown underneath, and it’s white on top, and we need to mix it up. But, you know, it has implications. And one of those implications is during the days of COVID-19. You know, we wonder why Black women had the highest standardized mortality, age-standardized mortality ratio in Canada, or Black people. And when you look and you see that, okay, who is actually the ones in the boardroom protected by the walls, and you know, not having patient contact, probably not Black, less likely to be Black. And who is the one protected, given that direct care, either, you know, as a practical nurse, a registered nurse, it is oftentimes much more likely to be Black.
Now, in terms of my experience, you know, in leadership, it’s been mostly in academia, and, you know, in the past, you know, I’ve been director of the Intersections of Gender institute where I reported to the Vice President Research. I’m also on several government of Canada advisory boards. I co-chair the Public Health Agency of Canada Advisory Committee on Science, and I’m also on the Social Sciences and Humanities Research Council, governing boards, governing council, as well as others.
Nam Kiwanuka
And said that it’s just in academia, but I imagine being, that’s also very important, we should say. But being the only one in the room, what has that taught you about leadership?
Dr. Bukola Salami
What has taught me about leadership is the importance of mentorship. And you know, we sort of see this in terms of, you know, when two Black people come into a faculty. Who gets nominated to be on the EDI committee, where you do work that is unrewarded, and who gets nominated to be on the grant review committee, where you learn skills and you strengthen your grant-writing skill. One is more likely to be a Black woman, and one is more likely to be white. So, when you’re now saying, you know, two, five years down the road, Black women are more likely to ascend the academic career ladder, then you wonder what inequities are embedded systemic inequities.
So, I have learned as a Black woman in the boardroom that, you know, some of the challenges is really the fact that oftentimes, you’re the only one. You know, there is a lot of tokenism that often happens, often happens in boardroom. And how do you speak out, and how do you actually strategize, in terms of pushing into addressing inequities. And sometimes, yes, the way to mentor others and build capacity, you want to be there, but you don’t want to be the last person to get there. And you’re always constantly thinking, how can I not be the last person to be in this position?
Nam Kiwanuka
The report spoke of something, the paradox of being highly visible. So, you are very noticeable in the environment, you can’t make mistakes, all those things, you’re the only one. And then, on the opposite side, being invisible when it comes to like promotions, that sort of thing. Dr. Maxwell, what’s it been like for you to be the only one in those rooms, and what has it taught you about leadership?
Dr. Cindy Maxwell
A few key words or themes come to mind for me. So, immense privilege, immense pressure, responsibility, and there’s a lot of joy, as well. So, we have to focus on the positive things, as well. In terms of the privilege, I feel it’s important to acknowledge that I do have the privilege of being able to sit at tables, to be at committees, where there are decisions being made, and where my voice is heard, and where I can contribute meaningfully to the work. And that privilege has been afforded to me through the excellent mentorship and sponsorship experiences that I’ve had. So, as Professor Salami had mentioned, mentorship is extremely important. And I don’t think any of us would be here without those mentors, those allies who helped position us, who helped support us, and who helped us advance in our work, in our health trajectories.
With that, then, comes responsibility to our communities. So, in the work that I do at Women’s College Hospital, I’ve had the privilege of being able to lead work to formulate something called our Black Health Plan, which is an action plan. So, it acknowledges what are the areas in health that need to be addressed within Black communities, for which our hospital has the ability to address, address those issues, and I’m able to be part of the accountability structure for implementing those initiatives. So, that’s powerful, and that’s amazing that we can do that, and I feel very privileged to be part of that process.
The responsibility to the community goes beyond implementing healthcare initiatives. It also means looking back, looking to the up-and-coming learners who require the same type of mentorship and support, so that they can advance. There are a lot of firsts, first Black person, first Black woman, you know, a lot of those things. And I think we, well, I don’t know about both of you, but sometimes I mark those moments just quietly, like, oh, wait, that happened, and did anybody notice, I’m not sure…
Nam Kiwanuka
We noticed.
Dr. Cindy Maxwell
…so those are wonderful, wonderful moments. Also, though, when you are a first, it’s a precedent setting, and so, people around you may not be ready for that precedent to be set. It may catch them off guard. One experience that comes to mind, I remember in one of my previous roles, I attended my first executive committee meeting, and I walked into a large official-looking room, a boardroom, with the oblong table, everybody seated, and it could have been my imagination, but my perception was that when I walked into the doors, all the eyes turned to me, because I could see the white of every person’s eyes, and I could have imagined it, but I thought that I heard an audible gasp.
Nam Kiwanuka
Well, you are quite striking, respectfully.
Dr. Cindy Maxwell
You know, I had my bright colors on and everything. But it’s, you know, so those moments, you have to be prepared for those, and have the confidence, the preparation, and all of those things to be able to handle those moments, and then still lead the work that’s important to you. Thinking of your community, as well as your responsibilities and accountabilities to the organization that you’re representing.
Nam Kiwanuka
We have seven minutes, really? Okay, we have seven minutes left. If you have any questions, please send them my way. I’m going to ask one more question, and then I really wanna get the audience’s questions, as well. Someone recently said to me in an interview that you measure what you treasure. This report is the first of its kind. There is a lack of data in Canada around race. Why is a report like this so important?
Dr. Modupe Tunde-Byass
You know, we always depended on United States for most things in Canada, especially the race-based data, even though the population are different, so we’ve not really collected any, you know, I would say robust, we have some, but not robust data. And it’s important to be able to collect the data, so you can measure and hold the system accountable. When you have a data, you cannot argue with that. You can use that data to change policies, to change people, and also, to address the inequity within the healthcare system. Let’s take an example of maternal mortality. We’ve heard in the United States two to three times, in the United Kingdom the same. But the data that we have, we have limited it in Ontario that follows the same pattern. Poverty and race, both of those are synergistic. So, if we’re having that in Ontario, there’s something that is common to all this. And we know there will be anti-Black racism and systemic discrimination that are the drivers of the health inequities that we see, especially in Black women. Until we collect race data, we’re not gonna be able to hold ourselves or the system accountable. So, I think that’s one very good reason why it’s important to collect those race-based data. So, I’ll let Bukola go, because of time.
Dr. Bukola Salami
I absolutely agree in terms of the need to collect race-based data. And if we don’t collect it, there is no way that we can fix it. But I think, oftentimes we often think, collecting race-based data is just the thing that is important for Black people. No, it affects us all. Whether you’re Black or non-Black. And case example is COVID-19 pandemic, okay?
Nam Kiwanuka
Can you expand on why it’s important for all of us?
Dr. Bukola Salami
Because, okay, for example, during COVID-19 pandemic, we thought anti-Black racism was only important to be addressed within Black communities. But then when we realized that if you don’t actually address COVID-19 morbidity and mortality in Black people, we are gonna get infected and we are gonna die. Then it really becomes not just a Black people thing, but it’s important for us all to address anti-Black racism that contributes to Black health inequities, and contributes on the long run to population health outcomes across Canada.
Nam Kiwanuka
Dr. Maxwell?
Dr. Cindy Maxwell
I think to paraphrase Kearie’s comment about the data being essential, like it is a life or death scenario for Black women, and for Black girls. The data is critical to identify those health trends, those inequities that impact us disproportionately. Dr. Tunde-Byass and I, we collaborate on a national health hub under the auspices of a CIHR Hub Grant. It’s one of 10 in the country, and it’s focused on justice and equity in perinatal health, and looking at the implementation and knowledge mobilization of some of the interventions that the community, the Black community has contributed in collaboration with science, to protect women and girls in their reproductive journey. And without the information to understand where, how to pinpoint the specific health issues to address, and then how to address them in a culturally safe manner in collaboration with Black communities is really the only way forward. So, I think that the data, it is a matter of life and death. We’re hearing now about menopause, and how Black women experience menopause over a longer duration of time.
Nam Kiwanuka
Earlier?
Dr. Cindy Maxwell
Earlier. That’s right, earlier. Maybe even earlier than we currently understand from the data, since the data was never collected, you know, specifically in Black communities, to be able to understand the Black experience. So, there is a lot of work to do, and we do, I think we need a national approach to collecting this data. So I think it’s a call to action from Kearie, and we’re ready to respond.
QUESTIONS & ANSWERS
Nam Kiwanuka
An opportunity. We only have time for one question. This is from Jasmine Barnett. As researchers and healthcare providers working in areas that directly impact Black women, how do you process the emotional weight of the findings while still producing objective rigorous work? Who’d like to take that?
Dr. Modupe Tunde-Byass
I can go. I think it’s very emotional just listening to this, and also reading, you know, most of the things that we know from inception, and understanding that these are historical. These are things that dated back to the time of slavery, and nothing has changed. We have eradicated smallpox, we’ve eradicated, you know, other diseases. HIV/AIDS is not an outpatient treatment, but anti-Black women racism isn’t. So, it’s something that can be changed if it becomes a priority.
Nam Kiwanuka
Thank you so much. I wish we had more time to speak, but much appreciation to you. A round of applause, please. And thanks so much for your attention, appreciate it.
Carrie Bois
Thank you to our panel and to our moderator, Nam, for such an engaging and eye-opening discussion. You’ve helped us see how evidence, advocacy, and lived experience come together to drive real change in Canada’s health systems. I also want to thank the Black Women’s Institute for Health, for their leadership in bringing this conversation and the Voices Unheard Report to the forefront. I hope everyone will take a look at the report, and take some time to talk about it in your own circles, because we all have a role to play in dismantling systems that negatively impact Black women and girls.
It’s now my pleasure to welcome a representative from the Canadian Medical Association, a fitting partner for today’s event. And before I introduce, I’ll graciously excuse the lovely panel, they’ve done their work, so thank you. The CMA is a champion of health equity and physician leadership across Canada, helping shape the systems and policies that determine how care is delivered and who it reaches. Please join me in welcoming former president, Joss Reimer.
Note of Appreciation by Joss Reimer, Former President, Canadian Medical Association
That was incredible. I feel so lucky to have been able to just sit there and absorb all of your experience, your expertise. So, I’m so thankful to the moderator, to the panellists, for sharing your vulnerability, alongside your expertise. I hope that other people in the room felt that they gained as much value and knowledge as I did. So, it was amazing to hear you shed light on the barriers for Black women, the barriers that they face in care, particularly when accessing care. We know that that’s an issue across the board, but we also know that it’s disproportionately affecting Black women and girls, and your insight has reminded us that health equity is not just a distant ideal. I like the ending summary that we heard from Dr. Tunde-Byass about how this is achievable, this is something we can do. And so, this is a daily responsibility.
The research, the strategy, the experiences that you have shared have challenged us all to confront uncomfortable truths, and commit to meaningful change. And so, thank you for your tireless work, for sharing with us today, but also the work you do every day pushing forward this issue and advancing women’s health, in particular, Black women’s health, and thank you to the Empire Club of Canada for bringing this together, and making sure that we all got to have this opportunity to talk about this important topic. It’s so wonderful to have these opportunities, and the CMA is very proud to play our small role in sponsoring this, because we know how important these conversations are. We can’t make these changes that we need to see without these conversations.
And so, at the CMA as well, we are advocating for a more equitable health system, where every Canadian can access the care that they need, when they need it, and when we try to achieve true equity, healthcare must start by acknowledging the systemic racism that continues to affect patients, but also providers. I’ve heard many stories from my colleagues about the racism that they face in their work every day. And so, this means we need to build a health system that is more grounded in trust, in cultural humility, in inclusive practices.
As you said, a lot of the data comes out of the US, but the data is also really clear that Black patients have better outcomes when they’re served by Black healthcare providers. And so, it’s not just about the equity for the providers, but it’s about creating a system that serves Canadians, all Canadians. And so, when I get asked about why do we support EDI, this isn’t just an ideal, it’s about creating a system that gives us better health outcomes. And we know the evidence supports that. That when you have someone that looks like you, that understands your experience in caring for you, you get better health outcomes. And so, this is something that I wanna see us continue to do, make sure that our workforce is strategically rooted in equity, diversity, in anti-racism, and that we champion the ethical collection and use of health data to identify and eliminate bias. Because as you clearly pointed out, without the collection of data, we can’t fix the problems.
So, we are committed at the CMA to continuing to amplify this message, to work with the leadership, with Black health experts and organizations—and I will flag that speaking of leadership, next year the CMA is going to have our first ever Black president, which I’m very proud of, but also, yes. That’s really wonderful, I also feel like we should maybe hesitate on a little bit of applause, because it shouldn’t have taken us 159 years of existence to have our first Black president. And I also wanna flag that we have not had a Black female president, and won’t have, and as much as I love our incoming president, he will be amazing, we heard very clearly that with intersectionality, the experience and expertise of Black women is unique. And so, I wanna steal, just a quick moment, because there’s a lot of people in this room who may know Black female physicians who you could encourage to run for CMA president, or other leadership opportunities, as well. Because I would really love to have somebody in that role, so that we can have another first, as you were talking about, the first Black female president of the Canadian Medical Association. So, maybe there even are people in this room who might be interested in running in the future.
But this is something that is true across all institutions, this is not unique to the CMA. And this progress requires collaboration within our institutions, across institutions, throughout communities, and today’s conversation is a really powerful step forward. So, I hope that if nothing else, we all take away that we all have a role in continuing to challenge systemic barriers to investing in solutions that reflect the diversity of our communities.
This year, there was an American pundit who made a very racist comment about how if a Black female surgeon walked in the room, he’d be really worried about how she got there, and whether or not he was gonna be cared for. And that one, I really just walked away feeling like if a Black female surgeon walks in as my surgeon, like, that I could be so lucky to have someone who has gotten to that stage, despite all the barriers. Like, she is probably the best in her class, the best surgeon I could possibly have, and I want to have more of that. So, today was just a really great example of what we can achieve when we bring these voices to the forefront. So, thank you for giving us the chance to be a small part of this, and thank you for everything that you shared with us.
Concluding Remarks by Carrie Bois
Thank you again to our panellists, sponsors, and of course, to all of you for joining us. I’d also like to take a moment to recognize the students and young leaders joining us today. Their presence is made possible through our charitable arm, the Empire Club Foundation, and the generosity of our donors. Can I please have the students stand? Just wanna, this is our future, a lot of healthcare future. So, thank you for joining us. This support enables us to invite future leaders to take part in today’s dialogue, and to empower them to turn knowledge into leadership that shines in communities, boardrooms, and national conversation shaping Canada’s future. Thank you.
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I also hope you’ll join us for two exciting upcoming events. On November 20th, we welcome the Honourable Prabmeet Sarkaria, Ontario’s Minister of Transportation, for “Protecting Ontario with Historic Investments in Transportation Infrastructure.” He’ll share how record investments in transit, highways, and bridges are helping build a stronger, more resilient Ontario. Then, on November 25th, Toronto City Councillor Brad Bradford joins us to talk about “The Future of Our City, How We Can Make Toronto Affordable, Safe, and Full of Opportunity Once Again.” Tickets for both events are on sale now.
As always, and as a club of record, all Empire Club events are available to watch and listen to our website. The recording of today’s event will be available shortly. Thank you for all being part of this important conversation, enjoying the networking reception, and we look forward to seeing you at future events. This meeting is now adjourned.
