During a pandemic, we forget that health is more than simply avoiding a virus. The more sinister attacks on our health have historically been, and continue to be, related to the “social determinants of health,” everything from income and employment to housing and education. One of those powerful determinants that can make Canadians squirmy is racism. Discussing racism causes eye contact to be avoided and chairs to be shifted. But even more uncomfortable is acknowledging the profoundly harmful b

I hover above the 15-minute post vaccine waiting area, light streaming in from the glass windows in the soaring atrium of the Peter Gilgan tower at St. Michael’s Hospital in downtown Toronto, scanning the masked figures below. Most are distracted on phones, sitting in the distanced wait room chairs, the deli counter number slips that will be called when their 15 minutes is up are crumpled in palms, damp with hand sanitizer.

Flexibility is the ability to bend without breaking. If we are all trees amidst a pandemic storm, the windy gusts of virus variants and vaccine delays are blowing our branches, hard. It’s been nearly a year now and many of us feel like we are going to snap: It’s bend or break time. Are we sheltering the storm by slipping under the sheets with a significant other? Surprisingly, no.

Decision-makers and staff in healthcare settings have a responsibility to take anti-racism action and may improve the success and sustainability of their efforts by incorporating the foundational principles and strategies identified in this paper. Keywords: anti-racism interventions; systemic racism; institutional racism; healthcare interventions; social determinants of health