Paediatric surgeon advances anti-racism in health care and medical education

From a young age, Dr. Oluwatomilayo (Tito) Daodu, MD, was exposed to the health inequities — gaps between the health of different groups — that exist between, and within, nations around the world.

Daodu was born in Nigeria before immigrating to Canada. She also spent time in the United Kingdom and Jamaica, which led to her interest in global and public health.

“My interest in medicine really stemmed from recognizing that not everybody has the same ability to attain good health,” says Daodu, a member of the O’Brien Institute for Public Health and the Alberta Children’s Hospital Research Institute at the Cumming School of Medicine (CSM), and a paediatric surgeon at Alberta Children’s Hospital.

As a researcher, Daodu studies health equity, focusing on improving surgical outcomes and making surgical care more accessible in Canada and around the world. Daodu says that while the role of surgeons in addressing public health concerns has often been neglected, they have an important part to play.

“When I decided on surgery as my career I started to re-examine what public health meant and how any specialty could fit into that. All health-care providers should care about what factors have determined the health of their patients — factors which oftentimes are out of their control.”

One such factor is systemic racism. Racism in health care, for example, disproportionately disadvantages patients who identify as Black, Indigenous, and People of Colour (BIPOC), says Daodu.  

There is a growing body of research showing that BIPOC patients have worse outcomes when seeking health care, surgery included. Health-care workers’ biases have been shown to lead to diagnostic delays, mistakes, and under-treatment of pain for BIPOC children, says Daodu.

However, simply being aware of the harmful effects of racism is not enough, she says.

The practice of identifying and eliminating racism and its harms is called anti-racism. This is an essential duty for all physicians, says Daodu.

Surgeons treat patients in their most vulnerable moments when racism can have its most devastating impact. They must become active advocates for change within their hospitals, organizations, and local and national governments.

Dr. Katrina Milaney, PhD, O’Brien Institute associate scientific director, population health, says the structural racism embedded in institutions and policies often continues because society chooses not to see it.

“Dr. Daodu’s expertise as a surgeon, educator and researcher means she is an essential part of the solution and we are fortunate to have her leadership. However, truly addressing structural racism falls to all of us,” says Milaney.

“Shining a light on inequities is an important first step, but solutions require reciprocity, respect and tangible action.”

Anti-racism in medical education

Dismantling racism in health care begins with education, says Daodu, who was recently appointed, along with Drs. Kannin Osei-Tutu, MD, and Nicole Johnson, MD, to co-lead the development of an updated curriculum at the CSM with anti-racism as a pillar.

“It’s amazing that my medical school is making a commitment that their graduates will understand issues of equity and inclusion,” says Daodu.

Chanda Mwansa with the University of Calgary’s Black Medical Students’ Association says an overhaul to medical school curricula across Canada is long overdue

“For far too long, medical education has been complicit in perpetuating racism and bias in the medical system,” she says.

The systemic nature of racism in medicine requires a holistic approach that begins with embedding diversity, equity, inclusion, and anti-racism into the admissions process for medical schools, and decolonizing medical education, says Mwansa.

“Non-white ethnic groups constitute the majority of the global population. When we plant seeds of anti-racism during medical education, we can better cultivate a medical system that is safe for people of the global majority.”

Daodu says one way medical education perpetuates racism is by treating race as a biological rather than a social construct, inferring that BIPOC are biologically different, unusual, or “less than.”

“It’s important to remember that a minuscule difference that makes one person's pigment different than another’s does not account for the whole fleet of differences in outcomes we see in BIPOC patients,” says Daodu.

Making anti-racism a core value in medical education will have far-reaching implications, says Mwansa. In Canada, racism remains a determinant of health that leads to inequalities in areas such as social inclusion, income, access to health services and quality of health services, she says.

“Racism is a public health crisis,” she says. “By putting in the work to graduate culturally dexterous physicians, the CSM can support a healthier future for all.”