McMaster professor Ingrid Waldron has had quite the journey over the past several years.
Her book on environmental racism in Nova Scotia, There’s Something in the Water, became a documentary co-directed by Canadian actor Elliot Page, alongside Ian Daniel. It premiered at the Toronto International Film Festival in 2019.
The spotlight helped put Waldron at the forefront of discussions in Canada on environmental racism and the author’s work was behind the push for a new law requiring the Canadian government to track how racialized groups have been disproportionately affected by polluting industries.
Waldron left Dalhousie University to return home to Ontario in 2021. She is now the HOPE Chair in Peace and Health in the Global Peace and Social Justice Program at McMaster University, where she continues to work on issues of environmental justice but has also returned to what she calls her “first love” — the study of mental health.
Waldron recently completed a study on the mental health issues facing Black youth in Hamilton and the challenges they have accessing services.
That work, along with previous studies involving the experiences of Black youth and women in Halifax and a long career in this field, informs her new book, From the Enlightenment to Black Lives Matter: Tracing the Impacts of Racial Trauma in Black Communities from the Colonial Era to the Present.
The book launches Feb. 12 at a McMaster University space in Hamilton’s Jackson Square.
In advance of the launch, CBC Hamilton executive producer Eva Salinas spoke with Waldron about the book, the need for change in the health-care system and how Canadians, including health-care practitioners and researchers, understand how racism impacts mental health.
The conversation has been edited for length and clarity.
Waldron: It was time to return to her ‘first love’
Did the move to McMaster inspire the book or did your interest in the topic draw you to McMaster?
Actually, neither one.
People see me so much in this space of environmental racism, but before I encountered that topic, I was fully engaged in mental illness, the impact of racism on mental illness in Black communities, and my PhD thesis back in 2002 [at OISE at the University of Toronto] was on the mental health impacts of racism on Black women.
So, I thought that that’s what I would continue to do.
It was only in 2008, as I mentioned in my book There’s Something In The Water, that an environmental activist came to me when I was at Dalhousie, asking me to do a project on environmental racism. So, it wasn’t something I knew anything about. It was new to me.
I said a few years ago, well, it’s time for me to kind of get back to my first love, which was, you know, mental illness, mental health issues in Black communities.
Were you thinking about the next generation of health-care practitioners at McMaster while writing about the structural changes you’d like to see in the sector?
Totally. I mean, one of the structural changes I mentioned in my book is a much more diverse health-care workforce. That’s a big one.
For a lot of participants that I spoke with, not seeing themselves when they go to a hospital to get care, not having enough nurses who look like them or nurses who may not understand where they’re coming from, their cultural orientations, and wanting to see people who look like them and also have similar cultures, is really, really important.
Being at McMaster, I see so many people of colour, racialized people, going into the health-care realm. They may not want to all be health professionals, but I supervise a lot of students from Global Health at McMaster — and that’s not my department. I’m in the Global Peace and Social Justice Program, but I can’t tell you the amount of racialized students who reach out to me who I don’t know from the Global Health department at McMaster saying, ‘Can you supervise me?’
What does that tell you?
It tells me that all programs and departments at universities need to hire much more faculty of colour, and they’ve told me that these students are reaching out to me because I’m a professor of colour, and they want a little bit of culture and race in the work that they’re doing and the courses that they’re attending, and they tell me they’re not getting much of that.
Elliot Page support was ‘shot in the arm’
Your last book, There’s Something in the Water, went on to become a documentary co-directed by Canadian actor Elliot Page. Can you share more about that journey?
I always say to people, it’s serendipity in some way that I was meant to do it. I don’t know why, because when I started it, I said, well, I’m not the person to do this. I’m not an environmental scientist or a climate scientist. Why is this environmental activist reaching out to me?
Then I realized I can put a different spin on it. Maybe I don’t know a lot about pollution and contaminants, but I’m a sociologist of health, and I’ll focus on the race and gender and the colonialism.
The Enrich Project in Halifax [which explored environmental racism in Nova Scotia] really became an engaging project for a lot of people. There were 400 people at my events at the central library in Halifax. Standing room only.
So, it was already popular before Elliot Page, but when Page came along, of course — when you mix celebrity with something like this — [it received] a shot in the arm.
The amount of attention that the documentary got, the amount of emails I got from people around the world saying, ‘I saw your documentary… I’m so inspired and the women in the film that you featured are so inspiring. Please tell me, Dr. Waldron, what can I do?’ I can’t tell you the amount of emails I’ve gotten, the emails I’ve gotten from students who say I want to do what you’re doing.
And then the increase in invitations to speak. There was a lot before Elliot Page, but now I get probably four or five invitations per week across Canada [and internationally]… So, without a doubt, that’s been a shot in the arm.
Now you’ve gone back to, as you say, your first love. In your new book, you say one of the challenges with doing analysis in the area of Black mental health is the lack of race-based data in Canada. How much has changed since your PhD?
It certainly has changed. I did my PhD starting in 1997, I finished it in 2002 and I had to turn to American literature on the impacts of racism on mental health, and maybe some British literature. There was virtually nothing in Canada about the impact of racism on mental health.
My PhD thesis, probably, was one of the first, if not the first [on the topic in Canada].
And now, so many people are talking about the structural determinants of health. That includes racism. The amount of people talking about race as a stressor, race as mental illness, has increased substantially, certainly among Black professors.
We see funders, grant funders, academic funders, creating funding streams that allow professors like myself to obtain grants on that topic, courses at Canadian universities on the structural determinants of health, where race is central, or courses on racism as a mental health issue or a health issue.
I think at McMaster right now, there’s another professor teaching it. I mean, things have changed drastically in this area.
Race-based data collection ‘really urgent’ in Canada
Can you elaborate more on the need for race-based data? Are you seeing the volume of that data increase in Canada?
That’s the problem. When I talk about what I have in my book, it’s qualitative data, right? We are still calling on the Government of Canada to collect race-based statistical data. That started to happen during COVID. So, Nova Scotia, Montreal and Toronto Public Health started collecting race-based data when we started to find out that South Asians and Black communities were disproportionately impacted by COVID. Now I hear that that’s not happening as much, that they’ve chosen not to do it. I think they’re still doing it in Nova Scotia.
What you’re referring to is race-based statistical data, and that’s still not happening. So, that’s really urgent. Because with that kind of data, unlike the qualitative data, we can say, like they say in the United States, Black men have higher rates of prostate cancer, which is the case in the U.S. They can say that in the United States because the government collects that type of data.
We don’t collect that type of data and you can imagine if we had that type of statistical data with our qualitative data — and qualitative data is about experiences and stories — how wonderful that would be. That allows somebody like myself to be able to bring all that together to provide evidence.
On the need to look at all forms of racism
One of the themes in your book is the lack of understanding of the impacts of racism on the health of those who have experienced it. It’s much more than how racism in a health-care setting can impact the quality of care, for instance.
Yes. So, what you’re referring to is that you might experience overt, direct forms of racism in a hospital or a health-care institution. And we certainly have talked about that. If you remember, there was an Indigenous woman [Joyce Echaquan] who experienced racism by a nurse. That got a lot of attention. But that’s direct, overt forms of racism, which Canadians focus on too much.
I think people have a difficulty understanding the subtle forms of racism and… structural racism, structural, anti-Black racism. I’m talking about specifically [racism] which occurs and is embedded within our social structures. It’s embedded within health care… criminal justice and policing. It’s embedded within the immigration system, within education, employment and labour.
What I’m arguing in the book is that there’s anti-Black racism embedded in all of those social structures, and that will have an impact on people’s emotional, psychological, spiritual and mental well-being. That’s what [people] don’t understand, because of not being able to understand structural and systemic forms of racism, how it embeds itself and how it’s entrenched within our social structures to a point where we can’t really see it and it’s not noticeable. It’s just how things are.
If we were to talk about structural racism within health-care institutions, that’s about programming, policies and services. How do those policies exclude, maybe in very subtle ways, people who are not white?
How does programming focus only on Western forms of knowledge and your Western modalities for treating illness when we have immigrant communities coming together to Canada with different ideas about illness, different ideas about how illness originates, different ideas about how illness should be treated? Many of their belief systems are not incorporated into our health-care system.
There’s so much focus on the kind of direct interactions that people have with one another, the interactions you have with a health professional that might seem racist, that’s also important, that’s definitely going to have an impact on your emotional well-being and your mental health.
But we need to look at all of it, right? Historic forms of racism, systemic, structural and direct forms of racism.
Have you seen the thinking at educational institutions and with service providers evolve when it comes to an understanding of the impacts of racism?
Certainly it’s gotten better since I did my PhD, but it’s not good enough, and it surprised me.
I thought when I was returning to the Greater Toronto and Hamilton Area, I would see progressive things happening… but in communicating with certain people in certain agencies or departments, and I’m asking about even climate justice or environmental justice or cultural competency — very basic things — and they’re not there yet. I’m really surprised by that.
I thought when I returned to Ontario, I’d be seeing much more work done in these areas. We see more Black professors, more Black individuals leading community-based health agencies who are speaking out, and some great things have happened in terms of grants and funders and philanthropic organizations providing more funding for this type of work.
But I’m actually surprised that we’re not farther ahead than we are. I really thought that when I returned, so much would be going on.
Just being here in Hamilton and trying to find mental health policymakers who want to connect with me on my recent study on Black youth and mental health in Hamilton has been a challenge, and I’ve been asking different people for suggestions who do this kind of work, and coming up with a blank so I find it’s extremely challenging, and I don’t think we’re where we should be, which is shocking to me.
You identify in your book a multi-level approach needed to address the challenges you describe.
Yeah, teaching and education in universities, it shouldn’t have to coincide with hiring more professors of colour, but obviously it has to, because right now, where things stand, I find that many of my students are not getting what they need.
They’re not being taught about issues around race in their courses. Professors probably don’t have expertise in that area, and in many of the departments in any university in Canada, there are not enough Black and other racialized folks being hired, and specifically Black folks.
When we think first off of medical schools and health professions, schools of nursing, schools of occupational therapy — when you’re going to be interacting directly with patients from around the world — training needs to improve around cultural competency and structural competencies.
A concept I talk about in my book [is] about professors getting out of the hospital system and identifying and finding partnerships with people outside the hospital — the legal aid clinic, with social workers, the people in the food bank. Some doctors might say that’s not my job, but many of the mental health issues that people are struggling with are not genetic or biologically derived. They have to do with the stress of daily living. So, if you’re not helping people with unemployment and underemployment and food security issues, then you’re not helping people.
We need to change the way we’re teaching students in the health professions and medical schools to look at structural competency and not just cultural competency.
Cultural competency means you’re empathic, you’re patient, you’re sensitive… great things to be, but that is not going to help somebody who’s dealing with unemployment and has severe mental health issues because they’ve been unemployed for so long. So, I think we need to change the way we’re teaching it.
Once you do that, then this new crop of students will see things differently, and if they chose to teach, they’re going to teach differently. And when they go into the health professions and become doctors and nurses and occupational therapists, they’re going to have that framework in their head, because their professor in medical school taught them that.
To me, that’s the root of it.
I also talk about research. Research is the root of it as well, because research informs teaching, and research often informs programming and mental health policy. So, more research dedicated to race and health, and race and mental health, and I’m talking about our major funders in Canada. SSHRC [Social Sciences and Humanities Research Council] and CIHR [Canadian Institutes of Health Research] are the academic funders. That’s changing a bit. I’m happy to say that I’m seeing funding streams now on the structural determinants of health and race, and I’m seeing that a little bit more now, but we need more.
We need funding streams for Black professors or Black research, or anyone who wants to do work regardless of their race, anyone who wants to do research on Black health and mental health.
I’m not asking the health system to do more. I’m asking the health system to do it differently.– Author Ingrid Waldron
And of course, mental health policy. You know, when I teach my students, and my students say to me, sometimes frustrated, ‘Dr. Waldron, you’re telling us all about this stuff, but nothing ever changes in Canada, everything stays the same. It’s frustrating.’
I say to them, you know why it stays the same? Because the mental health policymakers stay the same. If they’re not diversified, if they don’t look like me, if they continue to be white and middle class and able-bodied, then that’s how they’re going to view and navigate the world.
I don’t blame them for the fact that they were born white and middle class and they navigate the world in a particular way, but it just means that we need to diversify the people that we hire who are mental health policymakers, because then if we do that, they’re the root of it.
If we do that, then they’re going to develop mental health policies that understand the issues and challenges of people of colour, and then those mental health policies will inform mental health programming.
Racism is a ‘public health crisis’
What’s the risk if we don’t make these changes? People don’t get the care they need, there’s a continued strain on the healthcare system, what else?
Those things are real, but I think it also leads to a real public health crisis, because we were seeing more homelessness, unemployment, crime, horrific things happening in Toronto, which was a model city, at least to me it was a few years ago.
We will have a public health crisis — we already have one — among people of colour because of the racism that they’re facing.
I see increasing racism right now, particularly toward South Asian communities. Horrific. That is going to have an impact on their emotional, spiritual and mental well-being. People are going to respond in very aggressive ways. That’s normal. It has nothing to do with their race, as some people would think, but it’s a normal reaction to things happening in their lives that aren’t fair and unjust, right?
So, that’s what’s the scariest to me.
Yes, there’s a burden on the health-care system, but I’m not asking the health system to do more. I’m asking the health system to do it differently. That’s a difference. You don’t have to do anything more on the side of your desk. You need to think differently. You need to do it differently.
And doing it differently means, typically, that you are educated differently, once again, in medical schools and in the health professions.
